中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2011年
6期
449-454
,共6页
谭国林%马艳红%刘更盛%王建均%李维
譚國林%馬豔紅%劉更盛%王建均%李維
담국림%마염홍%류경성%왕건균%리유
鼻炎,变应性,常年性%去神经支配%内窥镜检查%治疗结果
鼻炎,變應性,常年性%去神經支配%內窺鏡檢查%治療結果
비염,변응성,상년성%거신경지배%내규경검사%치료결과
Rhinitis,allergic perennial%Denervation%Endoscopy%Treatment outcome
目的 评估鼻内镜下翼管神经切断术治疗中-重度持续性变应性鼻炎的临床疗效,探讨其可能的作用机制.方法 191例变应性鼻炎患者被分为3组,分别进行鼻内镜下翼管神经切断术(A组,71例)、下鼻甲部分切除和(或)鼻中隔矫正术(B组,39例)和保守治疗(C组,81例,对照组).应用鼻结膜炎生存质量调查问卷(rhinoconjunctivitis quality of life questionnaire,RQLQ)和视觉模拟量表(visual analogue scale,VAS)评估术前、术后6个月、1年和3年的鼻炎相关生活质量.结果 通过对145例资料完整的病例进行分析,经鼻内镜下翼管神经切断组(A组)RQLQ平均((x)±s,以下同)得分和VAS评分在术后6个月(0 84±0.41、2 55±1.57)、1年(0 91±0 43、2.63±1.71)、3年(1.03±0.46、2.81±1.75)都显著低于术前(2.25±0.49、7.34±1.11),F值分别为115.45、133.09,P值均<0.001,且分别低于B、C组治疗后6个月、1年、3年的RQLQ平均得分和VAS评分(P值均<0.001).患者对治疗后3 0～5.5年总体主观评估结果显示,A组显著改善率、改善率、无改善率分别为65.5%(38例)、24.1%(14例)、10.4%(6例),总体有效性显著高于B组(U=237.0,P<0.001)和C组(U=246.0,P<0.001).没有发生严重的手术并发症.结论 鼻内镜下翼管神经切断术是一种治疗中-重度持续性变应性鼻炎安全、有效的手段.
目的 評估鼻內鏡下翼管神經切斷術治療中-重度持續性變應性鼻炎的臨床療效,探討其可能的作用機製.方法 191例變應性鼻炎患者被分為3組,分彆進行鼻內鏡下翼管神經切斷術(A組,71例)、下鼻甲部分切除和(或)鼻中隔矯正術(B組,39例)和保守治療(C組,81例,對照組).應用鼻結膜炎生存質量調查問捲(rhinoconjunctivitis quality of life questionnaire,RQLQ)和視覺模擬量錶(visual analogue scale,VAS)評估術前、術後6箇月、1年和3年的鼻炎相關生活質量.結果 通過對145例資料完整的病例進行分析,經鼻內鏡下翼管神經切斷組(A組)RQLQ平均((x)±s,以下同)得分和VAS評分在術後6箇月(0 84±0.41、2 55±1.57)、1年(0 91±0 43、2.63±1.71)、3年(1.03±0.46、2.81±1.75)都顯著低于術前(2.25±0.49、7.34±1.11),F值分彆為115.45、133.09,P值均<0.001,且分彆低于B、C組治療後6箇月、1年、3年的RQLQ平均得分和VAS評分(P值均<0.001).患者對治療後3 0～5.5年總體主觀評估結果顯示,A組顯著改善率、改善率、無改善率分彆為65.5%(38例)、24.1%(14例)、10.4%(6例),總體有效性顯著高于B組(U=237.0,P<0.001)和C組(U=246.0,P<0.001).沒有髮生嚴重的手術併髮癥.結論 鼻內鏡下翼管神經切斷術是一種治療中-重度持續性變應性鼻炎安全、有效的手段.
목적 평고비내경하익관신경절단술치료중-중도지속성변응성비염적림상료효,탐토기가능적작용궤제.방법 191례변응성비염환자피분위3조,분별진행비내경하익관신경절단술(A조,71례)、하비갑부분절제화(혹)비중격교정술(B조,39례)화보수치료(C조,81례,대조조).응용비결막염생존질량조사문권(rhinoconjunctivitis quality of life questionnaire,RQLQ)화시각모의량표(visual analogue scale,VAS)평고술전、술후6개월、1년화3년적비염상관생활질량.결과 통과대145례자료완정적병례진행분석,경비내경하익관신경절단조(A조)RQLQ평균((x)±s,이하동)득분화VAS평분재술후6개월(0 84±0.41、2 55±1.57)、1년(0 91±0 43、2.63±1.71)、3년(1.03±0.46、2.81±1.75)도현저저우술전(2.25±0.49、7.34±1.11),F치분별위115.45、133.09,P치균<0.001,차분별저우B、C조치료후6개월、1년、3년적RQLQ평균득분화VAS평분(P치균<0.001).환자대치료후3 0～5.5년총체주관평고결과현시,A조현저개선솔、개선솔、무개선솔분별위65.5%(38례)、24.1%(14례)、10.4%(6례),총체유효성현저고우B조(U=237.0,P<0.001)화C조(U=246.0,P<0.001).몰유발생엄중적수술병발증.결론 비내경하익관신경절단술시일충치료중-중도지속성변응성비염안전、유효적수단.
Objective To evaluate the efficacy of endoscopic vidian neurectomy in the management of moderate-severe persistent allergic rhinitis, and to explore its possible mechanism. Methods One hundred and ninety-one patients with moderate-severe persistent allergic rhinitis were divided into three groups; endoscopic vidian neurectorny was carried out in 71 patients ( group A) , partial inferior turbenectomy and/or septal-plasty in 39 patients (group B) , and 81 patients were as control (group C).The life quality was assessed at 6 month, 1 year and 3 years after operation using rhinoconjunctivitis quality of life questionnaire (RQLQ ) and visual analogue scale (VAS). Results Among 191 cases, one hundred and forty-five cases had complete follow-up documents. The average score of RQLQ and VAS score ((x) ± s)were significantly decreased at the time of 6 months(0. 84 ±0. 41, 2. 55 ±1.57), 1 year(0.91 ±0.43,2.63±1.71)and 3 years (1.03 ±0.46,2.81 ± 1.75) after endoscopic vidian neurectomy than scores before operation (2. 25 ±0.49,7. 34 ± 1. 11) ,F = 115.45, 133. 09, respectively, P<0.001, and also significantly lower than scores in patients in group B or control group at the same period after treatment By patient's selfevaluation, the ratio of greatly-improved, improved and not-improved was respectively, 65.5% (38 cases) ,24. 1% (14 cases) , 10. 4% (6 cases) , and significantly higher in patients in group A than in patients in group B (U = 237.0, P<0.001) and group C( U = 246. 0,P <0. 001). There was no severe complication in all patients observed. Conclusion Endoscopic vidian neurectomy is an effective and safe technique in the management of moderate-severe persistent allergic rhinitis.
