慢性肥厚性鼻炎鼻内镜下不同术式临床疗效观察及术后相关因素分析

发布时间：2019-07-22 17:43

【摘要】：目的探讨鼻内镜手术治疗慢性肥厚性鼻炎临床疗效观察及影响术后嗅觉恢复相关因素。方法回顾性分析268例慢性肥厚性鼻炎患者的临床资料及手术效果,根据鼻内镜下手术方式不同分为A组(低温等离子射频消融术)75例,B组(改良下鼻甲成形术)78例,C组(下鼻甲黏膜下微波治疗术)70例,D组(行下鼻甲部分切除术)45例,观察其临床疗效及术后影响嗅觉恢复的相关因素。结果 A组总的有效率为97.06%,明显高于B组(82.80%)(P0.05)。A组并发症发生率为3.9%,明显优于B和D组(P0.05)。A组的手术时间、术中出血量、恢复通气时间、黏膜恢复时间及VAS评分均明显高于B和D组(P0.05);A组手术时间、恢复通气时间、黏膜恢复时间及VAS评分明显高于C组(P0.05),但术中出血量与C组差异无显著性(P0.05)。多因素logistic回归分析结果显示过敏因素是影响嗅觉恢复的独立危险因素。结论慢性肥厚性鼻炎手术方式众多,鼻内镜下低温等离子射频消融术效果优于其余3种治疗方法,具有有效率高、并发症少及术后恢复快等优点,可以作为目前相对有效和安全的治疗方法。
[Abstract]:Objective To study the clinical effect of nasal endoscopic surgery in the treatment of chronic hypertrophic rhinitis and the factors related to the recovery of olfaction after operation. Methods The clinical data and operative results of 268 patients with chronic hypertrophic rhinitis were analyzed retrospectively. In group C (under the submucous membrane of inferior turbinate),70 patients were treated with microwave treatment, and 45 cases were treated with D (inferior turbinate), and the clinical effect and the related factors that affect the olfactory recovery were observed. Results The total effective rate of group A was 97.06%, which was significantly higher than that in group B (82.80%) (P0.05). The complication rate of group A was 3.9%, which was better than that of group B and D (P0.05). The time of group A, the time of recovery and the time of recovery of mucosa and the score of VAS were significantly higher than that in group C (P0.05). The multivariate logistic regression analysis showed that the allergic factor was an independent risk factor that affected the olfactory recovery. Conclusion The effect of low-temperature plasma radiofrequency ablation on chronic hypertrophic rhinitis is superior to that of the remaining three methods. It has the advantages of high effective rate, less complication and quick recovery after operation, and can be used as a relatively effective and safe treatment method.
【作者单位】：山东省聊城市第二人民医院耳鼻喉科;
【分类号】：R765.21

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