黏膜下电凝术与低温等离子射频消融术治疗慢性肥厚性鼻炎的效果比较

摘要

目的:观察黏膜下电凝术治疗慢性肥厚性鼻炎的临床疗效.方法:97例鼻堵评分≥6分及至少一侧下鼻甲评分≥2分的慢性肥厚性鼻炎患者随机分为两组,分别采用黏膜下电凝术及等离子射频消融术治疗.于术后3、6个月应用视觉模拟评分表对鼻堵程度进行评分,对每侧下鼻甲进行评分,采用糖精试验测定鼻腔黏膜纤毛输送率(MTR),并与术前进行比较.结果:两组患者术前鼻塞程度评分、下鼻甲评分及MTR差异均无显著性(P>0.05).黏膜下电凝组术后3个月鼻塞程度评分为(1.55±0.33)分,较术前[(7.50±1.28)分]明显改善(P<0.01),与术后6个月[(1.47±0.39)分]比较无明显变化(P>0.05),与等离子组同时期相比无明显差别(P>0.05).术后3个月黏膜下电凝组下鼻甲评分为(1.43±0.27)分,较术前[(2.41±0.50)分]明显减小(P<0.01),与术后6个月[(1.21±0.47)分]比较无统计学差异(P>0.05),与等离子组同时期相比差异无统计学意义(P>0.05).两组术前术后MTR差别无统计学意义(P>0.05).结论:黏膜下电凝术术后效果与低温等离子消融术相似,是治疗慢性肥厚性鼻炎微创、安全、有效的方法,因方法简便更适于在基层普及.%Objective:To observe the therapeutic effect of submucous electrocoagulation on inferior turbinate hypertrophy in patients with chronic hypertrophic rhinitis. Methods: Ninety-seven patients, whose subjective symptoms scores of nasal obstruction were higher than 6,and at least scores of one inferior turbinate were higher than 2 , were involved in this study, and they were randomly divided into 2 groups. Fifty patients underwent submucous electrocoagulation reduction of inferior turbinate,and 47 were treated with coblation of inferior turbinate. Subjective symptoms scores of nasal obstruction and the inferior turbinate scores were assessed prior to,3 and 6 months after treatment. The mean nasal mucociliary transport rate (MTR) were also assessed 3 and 6 months after treatment by saccharic technique. Results:The subjective symptoms scores of nasal obstruction,inferior turbinate scores and MTR of the two groups had no significant difference prior to operation(P>0. 05). The scores of severity of nasal obstruction after 3 months in the submucous electrocoagulation group was 1. 55 ± 0. 33, which was significantly decreased compared to that prior to treatment (7. 50 ± 1. 28,P〈0. 01) ,and they were close to the scores 6 months after treatment (1. 47 ± 0. 39,P>0. 05 ). The difference was not significant between two groups at each time point(P>0. 05). The inferior turbinates were found significantly decreased in size after the treatment in the submucous electrocoagulation group (the score was 1. 43 + 0. 27 3 months after treatment vs. 2. 41 ± 0. 50 prior to treatment, P<0. 01) , and it was similar to that of 6 months after treatment (1. 21 ± 0. 47,P>0. 05). The difference was not significant between the two groups at either time point (P>0. 05). The changes in MTR were not significant in both two groups ( P> 0. 05). Conclusions: Submucous electrocoagulation inferior turbinectomy is a safe procedure,and it results in a significant improvement of nasal obstruction in patients with chronic hypertrophic rhinitis. This procedure is as effective as coblation inferior turbinectomy,and more applicable in grass-root hospitals because of easier operation and lower expense.