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
2013年
11期
891-894
,共4页
李佩忠%顾东升%陆美萍%李玉瑾%沈艳%程雷
李珮忠%顧東升%陸美萍%李玉瑾%瀋豔%程雷
리패충%고동승%륙미평%리옥근%침염%정뢰
鼻炎,变应性,常年性%消融技术%治疗结果%鼻激发试验%鼻腔测压%嗅觉
鼻炎,變應性,常年性%消融技術%治療結果%鼻激髮試驗%鼻腔測壓%嗅覺
비염,변응성,상년성%소융기술%치료결과%비격발시험%비강측압%후각
Rhinitis,allergic,perennial%Ablation techniques%Treatment outcome%Nasal provocation tests%Rhinomanometry%Smell
目的 观察鼻腔低温等离子消融术对持续性变应性鼻炎(allergic rhinitis,AR)的治疗效果.方法 纳入100例尘螨致敏的中-重度持续性AR患者为研究对象,其中男68例,女32例；年龄16 ～62岁,平均36.3岁.应用CoblatorⅡ型低温等离子治疗仪行双侧下鼻甲和鼻丘部位组织消融,手术前和手术后3个月采用视觉模拟量表(visual analogue scale,VAS)对患者鼻部总体症状进行评分,并且行鼻激发试验(nasal provocation test,NPT)、鼻阻力测量和T&T嗅觉测试,评价近期疗效.使用SPSS 19.0软件进行统计学分析.结果 ①术前鼻部总体症状VAS评分平均(x-±s,下同)为(7.0±2.0)分,术后3个月降为(2.5±1.5)分,差异有统计学意义(t =18.00,P=0.0001).②所有患者术前屋尘螨NPT均为阳性,术后3个月88例(88.0％)患者转为阴性,12例(12.0％)仍为阳性.③术前鼻腔总阻力为(0.772±0.224) kPa·s·L-,术后3个月降为(0.221±0.112)kPa·s·L-1,差异有统计学意义(t=22.00,P=0.0001).④术前31例(31.0％)患者嗅觉减退(轻度22例、中度9例),术后3个月13例(13.0％)患者仍有嗅觉减退(轻度7例、中度6例),差异有统计学意义(x2=10.44,P=0.005).结论 中-重度持续性AR行鼻腔低温等离子消融术可获得良好的近期疗效,对患者的鼻部症状、鼻黏膜高反应性以及鼻腔通气和嗅觉功能有明显改善作用,但远期疗效有待进一步观察.
目的 觀察鼻腔低溫等離子消融術對持續性變應性鼻炎(allergic rhinitis,AR)的治療效果.方法 納入100例塵螨緻敏的中-重度持續性AR患者為研究對象,其中男68例,女32例；年齡16 ～62歲,平均36.3歲.應用CoblatorⅡ型低溫等離子治療儀行雙側下鼻甲和鼻丘部位組織消融,手術前和手術後3箇月採用視覺模擬量錶(visual analogue scale,VAS)對患者鼻部總體癥狀進行評分,併且行鼻激髮試驗(nasal provocation test,NPT)、鼻阻力測量和T&T嗅覺測試,評價近期療效.使用SPSS 19.0軟件進行統計學分析.結果 ①術前鼻部總體癥狀VAS評分平均(x-±s,下同)為(7.0±2.0)分,術後3箇月降為(2.5±1.5)分,差異有統計學意義(t =18.00,P=0.0001).②所有患者術前屋塵螨NPT均為暘性,術後3箇月88例(88.0％)患者轉為陰性,12例(12.0％)仍為暘性.③術前鼻腔總阻力為(0.772±0.224) kPa·s·L-,術後3箇月降為(0.221±0.112)kPa·s·L-1,差異有統計學意義(t=22.00,P=0.0001).④術前31例(31.0％)患者嗅覺減退(輕度22例、中度9例),術後3箇月13例(13.0％)患者仍有嗅覺減退(輕度7例、中度6例),差異有統計學意義(x2=10.44,P=0.005).結論 中-重度持續性AR行鼻腔低溫等離子消融術可穫得良好的近期療效,對患者的鼻部癥狀、鼻黏膜高反應性以及鼻腔通氣和嗅覺功能有明顯改善作用,但遠期療效有待進一步觀察.
목적 관찰비강저온등리자소융술대지속성변응성비염(allergic rhinitis,AR)적치료효과.방법 납입100례진만치민적중-중도지속성AR환자위연구대상,기중남68례,녀32례；년령16 ～62세,평균36.3세.응용CoblatorⅡ형저온등리자치료의행쌍측하비갑화비구부위조직소융,수술전화수술후3개월채용시각모의량표(visual analogue scale,VAS)대환자비부총체증상진행평분,병차행비격발시험(nasal provocation test,NPT)、비조력측량화T&T후각측시,평개근기료효.사용SPSS 19.0연건진행통계학분석.결과 ①술전비부총체증상VAS평분평균(x-±s,하동)위(7.0±2.0)분,술후3개월강위(2.5±1.5)분,차이유통계학의의(t =18.00,P=0.0001).②소유환자술전옥진만NPT균위양성,술후3개월88례(88.0％)환자전위음성,12례(12.0％)잉위양성.③술전비강총조력위(0.772±0.224) kPa·s·L-,술후3개월강위(0.221±0.112)kPa·s·L-1,차이유통계학의의(t=22.00,P=0.0001).④술전31례(31.0％)환자후각감퇴(경도22례、중도9례),술후3개월13례(13.0％)환자잉유후각감퇴(경도7례、중도6례),차이유통계학의의(x2=10.44,P=0.005).결론 중-중도지속성AR행비강저온등리자소융술가획득량호적근기료효,대환자적비부증상、비점막고반응성이급비강통기화후각공능유명현개선작용,단원기료효유대진일보관찰.
Objective To evaluate the therapeutic effect of nasal coblation plasma surgery for the treatment of persistent allergic rhinitis (PAR).Methods One hundred patients with mite-sensitized moderate to severe PAR who underwent nasal coblation plasma surgery (inferior turbinoplasty plus nasal agger ablation) were enrolled in this study.There were 68 male and 32 female patients aged 16 to 62 years (mean,36.3 years).The visual analogue scale (VAS) for global rhinitis symptoms,nasal provocation test (NPT),anterior rhinomanometry,and T&T olfactometry were used to assess the short-term outcomes,preoperatively and postoperatively at the end of three months after surgical procedure.SPSS19.0 software was applied for statistical analysis.Results At three months after treatment,the total nasal symptom VAS scores significantly decreased from 7.0 ± 2.0 to 2.5 ± 1.5 (x-± s; t =18.00,P =0.0001).All patients were allergic to house dust mites with positive NPT before treatment.At three months from the coblation intervention,88.0％ of the patients changed from positive NPT to negative,while 12.0％ remained as positive.There was a significant reduction in total nasal resistance,which diminished from 0.772 ± 0.224 to 0.221 ±0.112 kPa · s · L-1 after treatment (t =22.00,P =0.0001).Preoperative olfactory tests showed hyposmia in 31.0％ of the patients,with 22 cases for slight and 9 cases for moderate disorder.Three months after treatment,13.0％ were diagnosed as hyposmic,with 7 cases for slight and 6 cases for moderate disorder (x2 =10.44,P =0.005).Conclusion Nasal coblation plasma surgery provides favorable shortterm outcomes in terms of remarkable improvement in nasal symptoms,hyperreactivity of nasal mucosa,nasal flow and olfactory function in patients with moderate to severe PAR,but long-term effect needed further observation.
