鼻内镜下二线减张法鼻中隔矫正术对变异性鼻炎伴鼻中隔偏曲患者疗效和血清炎性因子水平的影响

发布时间：2018-05-12 23:27

本文选题：鼻内镜 + 二线减张法　；参考：《中国老年学杂志》2015年19期

【摘要】：目的探讨鼻内镜下二线减张法鼻中隔矫正术对变异性鼻炎伴鼻中隔偏曲患者疗效和血清炎性因子水平的影响。方法随机选取2013年5月至2014年5月该院行鼻内镜下二线减张法鼻中隔矫正术治疗的伴鼻中隔偏曲的变异性鼻炎患者126例作为观察组,另选取30例同期行鼻内镜下三线减张法鼻中隔成形术治疗的伴鼻中隔偏曲的变异性鼻炎患者作为对照组。两组均接受相应的手术治疗且术后均计划随访1年。于治疗结束时统计两组疗效和并发症发生情况。分别于术前(T0)及术后1 d(T1)、1 w(T2)、1个月(T3)、3个月(T4)、6个月(T5)和1年(T6)时检测患者自觉鼻塞程度视觉模拟评分法(VAS)得分,采用酶联免疫吸附(ELISA)法检测同期血清肿瘤坏死因子(TNF)-α、白介素(IL)-4、IL-6等炎症因子水平。结果观察组疗效显著者比例高于对照组,治疗无效者比例低于对照组(P0.05)。观察组VAS评分和血清TNF-α、IL-4和IL-6水平均呈先升高后下降趋势且均于T1达到最高点,并于T6达到最低点。对照组VAS评分和血清TNF-α、IL-4和IL-6水平亦呈先升高后下降趋势,于T2达到最高点,并于T6达到最低点。观察组T2、T3、T4、T5、T6的VAS评分和血清TNF-α、IL-4和IL-6水平均低于对照组(P0.05)。观察组和对照组鼻中隔穿孔、鼻中隔血肿、鼻梁塌陷等并发症发生率比较差异无统计学意义(P0.05)。结论鼻内镜下二线减张法鼻中隔矫正术治疗伴鼻中隔偏曲的变异性鼻炎疗效显著,在有效缓解患者的临床症状和控制患者炎症的基础上并不会增加并发症的发生,具有良好的安全性和可行性,值得临床推广使用。
[Abstract]:Objective to investigate the effect of nasal septum correction with second line reduction of Zhang Fa under nasal endoscope on patients with septum deviation and the level of serum inflammatory factors. Methods from May 2013 to May 2014, 126 patients with nasal septum deviation treated by endoscopic second line subtraction Zhang Fa correction were randomly selected as the observation group. Another 30 patients with nasal septal deviation treated by endoscopic triple line subtraction nasoplasty (Zhang Fa) were selected as control group. Both groups received corresponding surgical treatment and planned to follow up for 1 year. At the end of the treatment, the curative effect and complications of the two groups were counted. The VASs were measured before operation (T0) and 1 day after operation (1 week after operation, 1 month after T3, 3 months with T4, 6 months with T5) and 1 year with T6). The serum levels of TNF- 伪, IL-4 and IL-6 in serum were measured by enzyme linked immunosorbent assay (Elisa). Results the proportion of patients with significant curative effect in the observation group was higher than that in the control group, and the rate of ineffective treatment was lower than that of the control group (P 0.05). The VAS score, serum TNF- 伪 IL-4 and IL-6 levels in the observation group increased first and then decreased, and reached the highest point at T1 and reached the lowest point at T6. In the control group, the VAS score, serum TNF- 伪 IL-4 and IL-6 levels increased first and then decreased, reaching the highest point at T2 and the lowest at T6. The VAS scores and serum TNF- 伪 -IL-4 and IL-6 levels in the observation group were lower than those in the control group (P 0.05). There was no significant difference between the observation group and the control group in the incidence of complications such as perforation of nasal septum, hematoma of nasal septum and collapse of nasal bridge. Conclusion the treatment of nasal septum with deviation of nasal septum by two-line subtraction Zhang Fa under nasal endoscope is effective and effective in relieving the clinical symptoms and controlling the inflammation of the patients, and does not increase the incidence of complications. It has good safety and feasibility and is worth popularizing in clinic.
【作者单位】：上饶市人民医院耳鼻喉科;
【分类号】：R765.9

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