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目的:探讨在鼻腔手术中联合应用等离子射频消融术治疗下鼻甲肥大及变应性鼻炎的疗效。方法:91例伴下鼻甲肥大及变应性鼻炎的鼻中隔偏曲或鼻息肉患者,行鼻中隔成形术或鼻内镜下鼻息肉摘除加筛窦开放术后,其中62例行等离子射频消融术(消融组),29例未行等离子射频消融术(对照组)。术前及术后3个月应用视觉模拟评分表(VAS)评价鼻塞的主观感觉。根据1997年海口会议疗效评定标准判断变应性鼻炎的疗效。结果:消融组术前鼻塞VAS评分左、右侧分别为(89.5±8.7)%和(90.3±10.5)%,术后3个月分别为(26.2±8.7)%和(32.1±10.3)%,左、右侧分别与术前比较,差异有统计学意义(均P<0.01);32例变应性鼻炎患者,显效31例(96.9%),有效1例(3.1%)。对照组术前鼻塞VAS评分左、右侧分别为(90.5±8.0)%和(89.9±11.5)%,术后3个月分别为(39.2±8.9)和(48.1±8.1)%,左、右侧分别与术前比较,差异均有统计学意义(均P<0.01);16例变应性鼻炎患者,显效4例(25.0%),有效10例(62.5%),无效2例(12.5%)。两组术后VAS评分差异有统计学意义(P<0.01)。结论:在鼻腔手术中联合应用等离子射频消融术治疗下鼻甲肥大及变应性鼻炎安全、有效。
Objective: To investigate the efficacy of combined plasma radiofrequency catheter ablation in the treatment of inferior turbinate hypertrophy and allergic rhinitis in nasal surgery. Methods: Totally 91 patients with nasal septum deviation or nasal polyps with inferior turbinate hypertrophy and allergic rhinitis underwent nasal septoplasty or nasal endoscopic polypectomy and ethmoid sinus surgery. Totally 62 patients underwent radiofrequency ablation Ablation group), 29 cases did not perform plasma radiofrequency ablation (control group). The subjective sensation of nasal obstruction was evaluated by visual analogue scale (VAS) before and 3 months after surgery. The efficacy of allergic rhinitis was judged according to the 1997 Haikou meeting evaluation standard of curative effect. Results: The preoperative nasal obstruction VAS scores of the ablation group were (89.5 ± 8.7)% and (90.3 ± 10.5)%, respectively, and were (26.2 ± 8.7) and (32.1 ± 10.3)% There were statistically significant differences between the two groups (all P <0.01). In 32 patients with allergic rhinitis, 31 cases (96.9%) were markedly effective and 1 (3.1%) effective. The left and right sides of the VAS score of the control group were (90.5 ± 8.0)% and (89.9 ± 11.5)%, respectively, and were 39.2 ± 8.9 and 48.1 ± 8.1% (P <0.01). In 16 patients with allergic rhinitis, 4 cases (25.0%) were markedly effective, 10 cases (62.5%) were effective, 2 cases (12.5%) were effective, and the difference was statistically significant ). There was significant difference in postoperative VAS score between the two groups (P <0.01). Conclusion: It is safe and effective to treat inferior turbinate hypertrophy and allergic rhinitis by combined plasma radiofrequency ablation in nasal surgery.