摘要
目的探讨治疗慢性肥厚性鼻炎理想的手术方法。方法144例慢性肥厚性鼻炎病例随机分为4组,80例慢性肥厚性鼻炎病人行鼻内镜下鼻甲黏膜下成形术(A组),26例行下鼻甲部分切除术(B组),30例行射频消融下鼻甲减容术(C组)和8例行下鼻甲硬化剂注射(D组)。分别比较4组术式治疗慢性肥厚性鼻炎的有效率、手术特点及术前术后下鼻甲黏膜超微结构变化。结果术后随访6个月,A组有效率为97.5%,B组为100%,C组为93.4%,D组为25%。A,B,C三组有效率比较无统计学意义(P>0.05),D组有效率低于其他3组,差异有统计学意义(P<0.05);A组下鼻甲黏膜纤毛结构保存完好,手术优点较其他3组术式突出。结论鼻内镜下鼻甲黏膜下成形术具有效、安全、微创,是治疗慢性肥厚性鼻炎较好的治疗方法。
Objective To find the better type of operation of chronic hypertrophic rhinitis （HR） t）y assessing the efficacy of various types and different features of operations. Methods 144 cases were selected randomly. 80 cases of HR were treated by transnasal endoscopic submucous inferior turt）inate resection （group A）, 26 cases by partial inferior turbinectomy （group B）, 30 cases by bipolar radiofrequency ablation on inferior turbinate （group C）, 8 cases by injection of sclerosing agent （group D）. Results Four groups of HR were followed up six months after operation, effective rate was 97. 5% in group A, 100% in group B, 93.4% in group C, 25% in group D, while effective rate had no significant difference statisfically among group A,group B and group C （ P 〉0. 05）. Group D effective rate had significant difference statistically among the four groups （ P 〈0. 05）. Scanning and transmission electron microscopy was performed to exam mucosa preoperatively and postoperatively the inferion turbinate in 6 cases with group A, in 2 cases with group B, group C and group D respectively. The examination of electron microscopy demonstrated that the inferior turbinate mucosas of group A remained perfect uhrastructure of mucosal cilia, while in other groups, the ultrastructure was impaired at 4 months postoperatively. Group A had more advantages than other groups. Conelusion The use of transnasal endoscopic submucous inferior turbinate resection is an effective modality for treatment of chronic hypertrophy rhinitis.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2006年第5期349-353,358,共6页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
上海市科学技术委员会立项课题资助项目(No.034119936)
作者简介
徐永昌，男．主任医师。通讯作者：徐永昌．Email：yongchangxu518@hotmail．com．
