摘要
目的比较等离子下鼻甲部分消融术与吸切钻下鼻甲部分切除术对慢性肥厚性鼻炎患者术中、术后的影响。方法等离子组患者25例,对照组14例。等离子组用低温等离子射频消融系统连接45号刀头,行下鼻甲前、后部中隔侧的4～6通道消融。对照组用吸切钻自前向后切割下鼻甲肥厚黏膜,术后需填塞止血2日。术后患者对疼痛和鼻堵程度采用VAS评分。术前、术后1个月、3个月、6个月均由医师对每侧下鼻甲进行评分,由患者评估鼻堵程度和频度。结果等离子组术中出血较对照组明显减少,术后疼痛和鼻堵程度较轻。术后1个月等离子组和对照组的鼻堵程度、鼻堵频度和下鼻甲体积较术前均有明显改善,二者改善的程度无明显差别。术后3个月两种术式均疗效稳定且等离子组鼻堵频度进一步改善。术后6个月两种术式疗效依然稳定。结论等离子下鼻甲部分消融术创伤小,术中、术后出血少,痛苦小;术后1个月患者主观症状与客观体征均有明显改善;术后3个月患者主观症状进一步改善;术后6个月内疗效均稳定且与吸切钻下鼻甲部分切除术疗效相当。
OBJECTIVE To compare coblation inferior turbinate reduction with inferior turbinectomy by evaluating the differences in the degree of intraoperative bleeding,degree of post-operative pain,and short-term efficacy in treating inferior turbinate hypertrophy. METHODS Thirty-nine patients were involved in this study. Twenty-five underwent coblation inferior turbinate reduction,and fourteen were treated with inferior turbinectomy with debrider. Subjective symptoms and the inferior turbinate scores were assessed prior to and at 1,3 and 6 months after treatment. In the coblation group,4-6 tunnels were made in each inferior turbinate with Reflex 45 wand under local anesthesia with endoscope. In the control group,debrider was used to remove the hypertropic mucosa of inferior turbinates under endoscope, after which nasal package were used for 2 days to stop the bleeding. RESULTS Coblation inferior turbinate reduction resulted in little intraoperative bleeding and a significant reduction in post-operative pain. At the month 1 follow-up,the severity and the frequency of nasal obstruction were significantly improved in both the coblation and control group. The inferior turbinates were found to have significantly decreased in size in both groups. There was no significant difference between the two groups. At the month 3 follow-up,these improvements were also significant,and the frequency of nasal obstruction was significantly more reduced in the coblation group. The results from the month 6 follow-up conformed to those from the month 3 followup. CONCLUSION Coblation inferior turbinectomy is a safe procedure that is easily performed under local anesthsia and results in a significant improvement of nasal obstruction in patients with turbinate hypertrophy. The volumes of the inferior turbinates were also significantly reduced. This procedure is as effective as inferior turbinectomy with debrider, The clinical benefit persists at 6 months after the procedure.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2006年第5期317-321,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
等离子
鼻甲
消融
吸切钻
Coblation
Turbinates
Reduction
Debrider
