临床诊疗

鼻内镜下应用低温等离子高选择性翼管神经分支切断治疗变应性鼻炎患者的疗效观察

:127-130
 
目的 研究鼻内镜下应用低温等离子高选择性翼管神经分支切断治疗变应性鼻炎患者的临床疗效。方法 选取我院2019年1月—2020年12月收治的60例变应性鼻炎患者,随机数字表法分为对照组(30例)和观察组(30例)。对照组行保守治疗,观察组行鼻内镜下低温等离子高选择性翼管神经分支切断术治疗。比较两组治疗前后Lund—Kennedy内镜黏膜形态评分、视觉模拟量表(VAS)评分,分析两组治疗前后炎症细胞因子[血清肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)、白介素-6(IL-6)]及鼻黏膜功能指标[血管活性常态肠肽(VIP)、鼻腔阻力(NR)、鼻黏膜纤毛传输时间(MTT)、鼻黏膜纤毛输送率(MTR)]变化情况。结果 两组治疗后VAS评分、Lund—Kennedy评分较治疗前降低(P<0.05);观察组治疗后VAS评分、Lund—Kennedy评分低于对照组(P0.05)。两组治疗后TNF-α、IL-4、IL-6水平较治疗前降低(P<0.05);观察组治疗后TNF-α、IL-4、IL-6水平低于对照组(P<0.05)。两组治疗后VIP、NR、MTT水平较治疗前降低(P<0.05),MTR水平较治疗前升高(P<0.05);观察组治疗后VIP、NR、MTT水平低于对照组(P<0.05),MTR水平高于对照组(P<0.05)。结论 鼻内镜下应用低温等离子高选择性翼管神经分支切断术治疗变应性鼻炎疗效显著,可改善鼻腔黏膜功能,减轻炎症反应,值得推广。
论著

鼻内镜鼻前庭囊肿揭盖术治疗鼻前庭囊肿的临床疗效

Clinical efficacy of nasal endoscopic nasal vestibular cyst uncovering for nasal vestibular cyst

:41-43
 
目的 探讨鼻内镜鼻前庭囊肿揭盖术治疗鼻前庭囊肿的临床疗效。方法 选择2014年8月-2017年8月我院收治的60例鼻前庭囊肿患者为研究对象,根据手术方式不同分为两组,每组各30例。对照组采用传统唇龈沟径路鼻前庭囊肿切除术进行治疗,观察组采用鼻内镜鼻前庭囊肿揭盖术治疗;评价两组手术情况、术后疼痛程度及并发症发生情况,术后随访1年,观察两组患者的复发情况。结果 对照组手术时间、术中出血量、术后住院时间分别为(44.78±8.13)min、(37.09±7.11)mL、(7.27±1.45)d均高于观察组的(17.91±4.26)min、(8.85±3.12)mL、(5.02±1.06)d,差异有统计学意义(P<0.05);对照组术后24 h、48 h、72 h的VAS评分分别为(3.53±1.07)分、(2.84±1.12)分、(2.34±0.69)分均高于观察组的(2.92±1.14)分、(2.21±1.00)分、(1.73±0.76)分,差异有统计学意义(P<0.05);对照组术后并发症发生率为26.67%,复发率为20.00%,高于观察组的6.67%、0.00%,差异有统计学意义(P<0.05)。结论 鼻内镜鼻前庭囊肿揭盖术治疗鼻前庭囊肿疗效显著,具有手术时间短、出血量少的优点,可减轻患者术后疼痛,减少术后并发症的发生,利于加速患者恢复,预后较好。
Objective To investigate the clinical efficacy of nasal endoscopic nasal vestibular cyst uncovering for nasal vestibular cyst. Methods Sixty patients with nasal vestibular cysts admitted to our hospital from August 2014 to August 2017 were enrolled in the study. They were divided into two groups according to different surgical methods,30 in each group. The control group was treated with traditional sacral sulcus cystectomy. The observation group was treated with nasal endoscopic nasal vestibular cyst uncovering for nasal vestibular cyst. The operation status,postoperative pain degree and complications were evaluated. After one year,the recurrence of the two groups of patients was observed. Results The operation time,intraoperative blood loss and postoperative hospital stay were (44.78±8.13) min,(37.09±7.11) mL,and (7.27±1.45)d,respectively,which were higher than the observation group (17.91±4.26) min. (8.85±3.12) mL,(5.02±1.06) d,the differences were statistically significant (P<0.05);the VAS scores of the control group at 24h,48h,72h were (3.53±1.07) points,(2.84±1.12). The scores of (2.34±0.69) were higher than those of the observation group (2.92±1.14),(2.21±1.00),and (1.73±0.76),the differences were statistically significant (P<0.05). The postoperative complication rate was 26.67%,and the recurrence rate was 20.00%,which was higher than that of the observation group (6.67%,0.00%). The differences were statistically significant (P<0.05). Conclusion Endoscopic nasal vestibular cyst is a significant treatment for nasal vestibular cyst. It has the advantages of short operation time and less bleeding. It may reduce postoperative pain,reduce postoperative complications,and accelerate the recovery of patients. It is good at prognosis.
临床诊疗

鼻内镜下三线减张矫正术治疗鼻中隔偏曲的疗效及安全性观察

Safety and curative effect of nasal endoscope three line diorthosis in treatment of deviation of nasal septum

:96-98
 
目的 研究鼻内镜下三线减张矫正术治疗鼻中隔偏曲的疗效及安全性。方法 纳入2010年9月—2015年9月我院120例鼻中隔偏曲患者作为研究对象,采用随机数表法分为两组,各60例。观察组行鼻内镜下三线减张鼻中隔偏曲矫正术,对照组行鼻内镜下传统鼻中隔黏膜下切除术。比较两种手术方法对患者鼻塞、头痛、鼻出血等临床症状的改善情况,随访记录两组术后疼痛、鼻阻力及并发症发生情况,评价疗效和安全性。结果 观察组术后鼻塞、头痛及鼻出血症状评分分别为(1.05±0.16)分、(1.3±0.14)分及(1.63±0.14)分,均显著低于对照组和术前水平(P<0.05)。观察组术后1周、2周及4周各时间点VAS评分和鼻阻力值均显著低于对照组(P<0.05)。观察组术后鼻中隔血肿和黏膜撕裂发生率均为1.67%,无鼻中隔穿孔和外形改变病例,发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 鼻内镜下三线减张矫正术能显著改善鼻中隔偏曲患者鼻塞、头痛及鼻出血症状,促进鼻腔通气功能恢复,有效降低术后并发症发生率,安全性高。
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