鼻中隔矫正联合筛前神经射频消融治疗变应性鼻炎伴鼻中隔偏曲的疗效分析(1)
摘 要:目的 探讨鼻中隔矫正联合筛前神经射频消融治疗变应性鼻炎伴鼻中隔偏曲的疗效。方法 选取81例就诊于我科的变应性鼻炎伴鼻中隔偏曲患者,随机分为对照组40例和治疗组41例。对照组采用鼻中隔矫正术治疗,治疗组采用鼻中隔矫正联合射频消融治疗。观察两组治疗后3个月、6个月和1年的临床疗效以及并发症情况。结果 两组患者术后3个月治疗总有效率比较,差异无统计学意义(P>0.05);治疗组患者术后6个月和术后1年的治疗总有效率分别为85.00%和82.50%,均高于对照组的63.41%和58.54%,差异具有统计学意义(P<0.05)。手术病例均未见鼻中隔穿孔、鼻腔粘连、下鼻甲萎缩等严重并发症。结论 相对于单纯鼻中隔矫正术,鼻中隔矫正联合筛前神经射频消融治疗变应性鼻炎伴鼻中隔偏曲的远期疗效明显,安全性较高。
关键词:变应性鼻炎;鼻中隔偏曲;射频消融
中图分类号:R765.21 文献标识码:A DOI:10.3969/j.issn.1006-1959.2018.23.030
, http://www.100md.com
文章编号:1006-1959(2018)23-0111-03
Abstract:Objective To observe the curative effects of nasal septal reconstruction combined with radiofrequency ablation in treatment of allergic rhinitis patients with septal deviation. Methods 81 cases of moderate to severe AR patients with septal deviation were recruited and divided into control group(n=41) and observation group(n=40).Patients in control group were treated with nasal septal reconstruction,while patients in observation group received nasal septal reconstruction combined with nervus ethmoidalis anterior under radiofrequency ablation.The curative effects were assessed at 3 months,6 months and 1 year after operation. Results 3 months later,there was no significant difference in the total effective rate between the two groups (P>0.05). The total effective rate of treatment in the treatment group was 85.00% and 82.50% at 6 months and 1 year after operation, were higher than the control group of 63.41% and 58.54%, the difference was statistically significant (P<0.05). No serious complications such as nasal septum perforation, nasal adhesions, and inferior turbinate atrophy were observed in the surgical cases. Conclusion Compared with simple nasal septum correction, the long-term effect of nasal septum correction combined with pre-screening nerve radiofrequency ablation for allergic rhinitis with nasal septum deviation is obvious and safe.
, 百拇医药
Key words:Allergic rhinitis;Nasal septal reconstruction;Radio frequency
變应性鼻炎(allergic rhinitis,AR)是耳鼻咽喉科最为常见的疾病之一。随着工业化的不断发展,AR发病率逐年上升,已成为危害公众健康的常见疾病。流行病学研究显示,AR的患病率为10%~30%[1],国内患病率的Meta分析结果显示,国内儿童AR患病率为15.79%,成人AR患病率为13.26%[2],且近年来发病率呈明显上升趋势[3]。目前治疗AR的主要方法包括变应原回避、药物治疗、免疫治疗和手术治疗,对于伴有鼻中隔偏曲的AR患者,在予以系统内科保守治疗后,大部分患者疗效较差,根据国内外相关经验及指南,如美国耳鼻咽喉头颈外科学会2015年发布《变应性鼻炎临床实践指南》指出,在评估可利用的有效证据和权衡各种AR的诊断和治疗利弊的基础上,对药物治疗无效又伴有鼻阻塞和下鼻甲肥大的AR患者,临床医师可以行下鼻甲缩小的手术(证据等级C)[4]。对于此类患者,行鼻内镜和鼻窦CT检查常提示其伴有鼻中隔偏曲,我们根据指南及相关经验,对该类伴有鼻中隔偏曲的AR患者,采用鼻中隔矫正联合筛前神经射频消融术治疗,术后随访1年,现报告如下。
, 百拇医药
1资料与方法
1.1一般资料 选取2016年3月~2017年3月在安徽医科大学附属安庆医院耳鼻喉科就诊的伴有鼻中隔偏曲的AR患者81例,本研究经医院伦理会批准。所有病例按入院先后随机分为对照组和治疗组。对照组41例中,男19例,女22例,年龄18~50岁,平均年龄(24.05±6.88)岁;病程2~13年,平均病程(4.65±2.52)年;术前总症状体征评分(27.19±4.88)分。治疗组40例中,男22例,女18例,年龄18~52岁,平均年龄(23.75±7.82)岁;病程1~14年,平均病程(4.71±2.83)年;术前总症状体征评分(26.96±5.43)分。两组患者性别、年龄、病程、术前总症状体征评分等资料比较,差异无统计学意义(P>0.05),具有可比性。, 百拇医药(朱志成 陈玉赞)
关键词:变应性鼻炎;鼻中隔偏曲;射频消融
中图分类号:R765.21 文献标识码:A DOI:10.3969/j.issn.1006-1959.2018.23.030
, http://www.100md.com
文章编号:1006-1959(2018)23-0111-03
Abstract:Objective To observe the curative effects of nasal septal reconstruction combined with radiofrequency ablation in treatment of allergic rhinitis patients with septal deviation. Methods 81 cases of moderate to severe AR patients with septal deviation were recruited and divided into control group(n=41) and observation group(n=40).Patients in control group were treated with nasal septal reconstruction,while patients in observation group received nasal septal reconstruction combined with nervus ethmoidalis anterior under radiofrequency ablation.The curative effects were assessed at 3 months,6 months and 1 year after operation. Results 3 months later,there was no significant difference in the total effective rate between the two groups (P>0.05). The total effective rate of treatment in the treatment group was 85.00% and 82.50% at 6 months and 1 year after operation, were higher than the control group of 63.41% and 58.54%, the difference was statistically significant (P<0.05). No serious complications such as nasal septum perforation, nasal adhesions, and inferior turbinate atrophy were observed in the surgical cases. Conclusion Compared with simple nasal septum correction, the long-term effect of nasal septum correction combined with pre-screening nerve radiofrequency ablation for allergic rhinitis with nasal septum deviation is obvious and safe.
, 百拇医药
Key words:Allergic rhinitis;Nasal septal reconstruction;Radio frequency
變应性鼻炎(allergic rhinitis,AR)是耳鼻咽喉科最为常见的疾病之一。随着工业化的不断发展,AR发病率逐年上升,已成为危害公众健康的常见疾病。流行病学研究显示,AR的患病率为10%~30%[1],国内患病率的Meta分析结果显示,国内儿童AR患病率为15.79%,成人AR患病率为13.26%[2],且近年来发病率呈明显上升趋势[3]。目前治疗AR的主要方法包括变应原回避、药物治疗、免疫治疗和手术治疗,对于伴有鼻中隔偏曲的AR患者,在予以系统内科保守治疗后,大部分患者疗效较差,根据国内外相关经验及指南,如美国耳鼻咽喉头颈外科学会2015年发布《变应性鼻炎临床实践指南》指出,在评估可利用的有效证据和权衡各种AR的诊断和治疗利弊的基础上,对药物治疗无效又伴有鼻阻塞和下鼻甲肥大的AR患者,临床医师可以行下鼻甲缩小的手术(证据等级C)[4]。对于此类患者,行鼻内镜和鼻窦CT检查常提示其伴有鼻中隔偏曲,我们根据指南及相关经验,对该类伴有鼻中隔偏曲的AR患者,采用鼻中隔矫正联合筛前神经射频消融术治疗,术后随访1年,现报告如下。
, 百拇医药
1资料与方法
1.1一般资料 选取2016年3月~2017年3月在安徽医科大学附属安庆医院耳鼻喉科就诊的伴有鼻中隔偏曲的AR患者81例,本研究经医院伦理会批准。所有病例按入院先后随机分为对照组和治疗组。对照组41例中,男19例,女22例,年龄18~50岁,平均年龄(24.05±6.88)岁;病程2~13年,平均病程(4.65±2.52)年;术前总症状体征评分(27.19±4.88)分。治疗组40例中,男22例,女18例,年龄18~52岁,平均年龄(23.75±7.82)岁;病程1~14年,平均病程(4.71±2.83)年;术前总症状体征评分(26.96±5.43)分。两组患者性别、年龄、病程、术前总症状体征评分等资料比较,差异无统计学意义(P>0.05),具有可比性。, 百拇医药(朱志成 陈玉赞)