不同术式对慢性肥厚性鼻炎治疗的疗效对比(1)
[摘要] 目的 探讨不同术式对慢性肥厚性鼻炎的治疗效果。方法 整群选择于2013年5月—2015年1月来该院进行手术治疗的慢性肥厚性鼻炎患者213例，随机分为3组，A组行下鼻甲黏膜成形术，B组行下鼻甲骨折外移术，C组行低温等离子消融术，每组各71例患者，对比观察3组患者的手术治疗效果。结果 在手术后3个月时，3组的治疗效果差异无统计学意义(P>0.05)；在手术后1年时，A组的总有效率为92.95%，B组的总有效率为71.83%，C组的总有效率为74.65%，A组的总有效率为均高于B组和C组，且差异有统计学意义(P<0.05)。结论 从长远治疗效果看，下鼻甲黏膜成形术的手术治疗效果明显优于下鼻甲骨折外移术和低温等离子消融术，值得在临床上推广应用。
[关键词] 不同术式；慢性肥厚性鼻炎；疗效
[中图分类号] R765.9 [文献标识码] A [文章编号] 1674-0742(2016)05(a)-0004-03
[Abstract] Objective To study the effect of different operative methods in treatment of chronic hypertrophic rhinitis. Methods 213 cases of patients with chronic hypertrophic rhinitis receiving operative treatment in our hospital from May 2013 to January 2015 were selected and randomly divided into three groups with 71 cases in each， the group A were treated with submucous inferior turbinate resection， the group B were treated with inferior turbinectomy， the group C were treated with plasma radiofrequency treatment at low temperature， and the operative treatment effects of the three groups were compared and observed. Results There was no obvious difference in the treatment effect between the three groups at 3-month after operation without statistical significance(P>0.05)， the total effective rate was 92.95% in the group A， 71.83% in the group B and 74.65% in the group C at 1-year after operation， the total effective rate in the group A was higher than that in the group B and group C， and the difference was obvious with statistical significance(P<0.05). Conclusion In the long run， the operative treatment effect of submucous inferior turbinate resection is obviously better than that of inferior turbinectomyn and plasma radiofrequency treatment at low temperature， which is worth clinical promotion and application.
[Key words] Different operative methods； Chronic hypertrophic rhinitis； Curative effect
慢性肥厚性鼻炎是一种以鼻黏膜及黏膜下层，甚至骨膜、骨组织的弥漫性或局限性增生肥厚为显著特点的慢性炎症，病变以下鼻甲最显著，临床表现主要为鼻塞，鼻通气障碍[1]，该病严重影响了患者的生活质量，该患者造成了巨大的疼苦。慢性肥厚性鼻炎的治疗主要是改善患者的鼻腔通气[2]，药物治疗无效的患者常会行微波、射频、下鼻甲切除术等治疗，可改善患者的临床症状。目前，随着医疗水平的逐渐发展，越来越多的治疗方法被应用于慢性肥厚性鼻炎的治疗中。该研究通过对于2013年5月—2015年1月来该院行手术治疗的213例慢性肥厚性鼻炎患者进行对比分析，来探讨不同术式的治疗效果，为临床应用提供一定的参考，现报道如下。
1 资料与方法
1.1 一般资料
整群选择于2013年5月—2015年1月来该院进行手术治疗的慢性肥厚性鼻炎患者213例，随机分为3组，A组行下鼻甲黏膜成形术，B组行下鼻甲骨折外移术，C组行低温等离子消融术，每组71例患者。其中A组男性39例，女性32例，年龄22～63岁，平均年龄(41.42±3.2)岁，患者病程为2年半～9年，平均病程为(4.50±0.2)年。B组男性39例，女性32例，年龄为20～60岁，平均年龄为(43.21±3.1)岁，病程2～9年半，平均病程为(5.40±0.2)年。C组男性38例，女性33例，年龄为19～65岁，平均年龄为(42.57±3.5)岁，患者病程为3～8年，平均病程为(4.80±0.5)年。所有患者均符合相关临床诊断学标准，表现为严重鼻塞，患病时间较长，鼻镜检查显示患者鼻腔黏膜呈暗红色或淡红色，下鼻甲表现为结节状肥大或桑葚样，且经一般的药物治疗无效。经鼻内镜检查显示下鼻甲肥大伴鼻中隔偏曲者82例，变应性鼻炎下鼻甲黏膜肥厚者45例，下鼻甲黏膜增生肥厚者48例，下鼻骨肥大增生者38例。所选患者均无严重心脏、肝脏、肾脏、循环系统等功能紊乱，无结构性鼻炎及鼻息肉等，无慢性鼻炎手术史等情况。3组患者在性别、年龄、病程及病变类型间差异不明显，差异无统计学意义(P>0.05)，因此3组间具有可比性。 (赵伟)
[关键词] 不同术式；慢性肥厚性鼻炎；疗效
[中图分类号] R765.9 [文献标识码] A [文章编号] 1674-0742(2016)05(a)-0004-03
[Abstract] Objective To study the effect of different operative methods in treatment of chronic hypertrophic rhinitis. Methods 213 cases of patients with chronic hypertrophic rhinitis receiving operative treatment in our hospital from May 2013 to January 2015 were selected and randomly divided into three groups with 71 cases in each， the group A were treated with submucous inferior turbinate resection， the group B were treated with inferior turbinectomy， the group C were treated with plasma radiofrequency treatment at low temperature， and the operative treatment effects of the three groups were compared and observed. Results There was no obvious difference in the treatment effect between the three groups at 3-month after operation without statistical significance(P>0.05)， the total effective rate was 92.95% in the group A， 71.83% in the group B and 74.65% in the group C at 1-year after operation， the total effective rate in the group A was higher than that in the group B and group C， and the difference was obvious with statistical significance(P<0.05). Conclusion In the long run， the operative treatment effect of submucous inferior turbinate resection is obviously better than that of inferior turbinectomyn and plasma radiofrequency treatment at low temperature， which is worth clinical promotion and application.
[Key words] Different operative methods； Chronic hypertrophic rhinitis； Curative effect
慢性肥厚性鼻炎是一种以鼻黏膜及黏膜下层，甚至骨膜、骨组织的弥漫性或局限性增生肥厚为显著特点的慢性炎症，病变以下鼻甲最显著，临床表现主要为鼻塞，鼻通气障碍[1]，该病严重影响了患者的生活质量，该患者造成了巨大的疼苦。慢性肥厚性鼻炎的治疗主要是改善患者的鼻腔通气[2]，药物治疗无效的患者常会行微波、射频、下鼻甲切除术等治疗，可改善患者的临床症状。目前，随着医疗水平的逐渐发展，越来越多的治疗方法被应用于慢性肥厚性鼻炎的治疗中。该研究通过对于2013年5月—2015年1月来该院行手术治疗的213例慢性肥厚性鼻炎患者进行对比分析，来探讨不同术式的治疗效果，为临床应用提供一定的参考，现报道如下。
1 资料与方法
1.1 一般资料
整群选择于2013年5月—2015年1月来该院进行手术治疗的慢性肥厚性鼻炎患者213例，随机分为3组，A组行下鼻甲黏膜成形术，B组行下鼻甲骨折外移术，C组行低温等离子消融术，每组71例患者。其中A组男性39例，女性32例，年龄22～63岁，平均年龄(41.42±3.2)岁，患者病程为2年半～9年，平均病程为(4.50±0.2)年。B组男性39例，女性32例，年龄为20～60岁，平均年龄为(43.21±3.1)岁，病程2～9年半，平均病程为(5.40±0.2)年。C组男性38例，女性33例，年龄为19～65岁，平均年龄为(42.57±3.5)岁，患者病程为3～8年，平均病程为(4.80±0.5)年。所有患者均符合相关临床诊断学标准，表现为严重鼻塞，患病时间较长，鼻镜检查显示患者鼻腔黏膜呈暗红色或淡红色，下鼻甲表现为结节状肥大或桑葚样，且经一般的药物治疗无效。经鼻内镜检查显示下鼻甲肥大伴鼻中隔偏曲者82例，变应性鼻炎下鼻甲黏膜肥厚者45例，下鼻甲黏膜增生肥厚者48例，下鼻骨肥大增生者38例。所选患者均无严重心脏、肝脏、肾脏、循环系统等功能紊乱，无结构性鼻炎及鼻息肉等，无慢性鼻炎手术史等情况。3组患者在性别、年龄、病程及病变类型间差异不明显，差异无统计学意义(P>0.05)，因此3组间具有可比性。 (赵伟)