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下鼻甲黏膜下切除术对常年性变应性鼻炎患者的长期影响。

Long-term effect of submucous turbinectomy in patients with perennial allergic rhinitis.

作者信息

Mori Shigehito, Fujieda Shigeharu, Yamada Takechiyo, Kimura Yuichi, Takahashi Noboru, Saito Hitoshi

机构信息

Department of Otorhinolaryngology, National Sanatorium Fukui Hospital, Fukui Medical University, Japan.

出版信息

Laryngoscope. 2002 May;112(5):865-9. doi: 10.1097/00005537-200205000-00016.

Abstract

OBJECTIVES

The long-term effect of submucous turbinectomy for patients with perennial allergic rhinitis was assessed.

STUDY DESIGN

A cohort study of 45 patients with severe perennial allergic rhinitis who underwent submucous turbinectomy and were followed up after surgery for more than 3 years was performed. We investigated quality of life in 30 of 45 patients who had passed over 5 years after the surgery.

METHODS

Nasal symptoms were assessed with a standard symptom score by diary cards. Nasal congestion was evaluated by rhinometry. Nasal challenge tests in vivo were performed to evaluate allergic reactions. These examinations were performed before surgery and at 1 year, more than 3 years, and more than 5 years after submucous turbinectomy. We determined the symptom scores and the quality of life using card questionnaires in 30 patients at the time point of more than 5 years after surgery.

RESULTS

The mean [+/- SD] total nasal symptom score (maximum 9) was significantly lower at 1 year after surgery (7.5+/-1.6 vs. 1.8+/-1.8, P <.0001) compared with before surgery. A significant improvement in nasal symptoms was noted at the 3-year (2.8+/-2.3, P <.0001) and 5-year (3.3+/-1.6, P <.0001) time points. A significant increase in total nasal airflow value was noted at each time point after surgery, with a gradual reduction in the total nasal symptom score as well (before surgery, 269.4+/-249.5 cm3/s; 1 y after surgery, 450.1+/-197.7 cm3/s; more than 3 y after surgery, 385.1+/-182.3 cm3/s). The nasal challenge test score was also reduced 1 year after surgery (2.1+/-1.0 vs. 0.6+/-0.7, P <.0001). However, there was no further significant increase at the 3-year time point (0.4+/-0.7, P <.0001) after surgery. In regard to postoperative quality of life, according to the results of the card questionnaire, 50% of the patients had not been receiving antiallergic treatments in the postoperative period.

CONCLUSION

Our results suggest that submucous turbinectomy is a useful strategy for the longterm management of nasal allergic reaction and contributes to the improvement in quality of life.

摘要

目的

评估下鼻甲黏膜下切除术对常年性变应性鼻炎患者的长期疗效。

研究设计

对45例重度常年性变应性鼻炎患者进行队列研究,这些患者接受了下鼻甲黏膜下切除术,并在术后进行了3年以上的随访。我们调查了45例患者中术后超过5年的30例患者的生活质量。

方法

通过日记卡用标准症状评分评估鼻部症状。用鼻阻力计评估鼻阻塞情况。进行体内鼻激发试验以评估过敏反应。这些检查在手术前以及下鼻甲黏膜下切除术后1年、3年以上和5年以上进行。我们在术后5年以上的时间点用卡片问卷对30例患者进行症状评分和生活质量评估。

结果

术后1年时,平均[±标准差]总鼻部症状评分(最高9分)显著低于术前(7.5±1.6对1.8±1.8,P<.0001)。在术后3年(2.8±2.3,P<.0001)和5年(3.3±1.6,P<.0001)时间点,鼻部症状有显著改善。术后各时间点鼻总气流值均显著增加,同时总鼻部症状评分也逐渐降低(术前,269.4±249.5cm³/s;术后1年,450.1±197.7cm³/s;术后3年以上,385.1±182.3cm³/s)。术后1年鼻激发试验评分也降低(2.1±1.0对0.6±0.7, P<.0001)。然而,术后3年时间点无进一步显著改善(0.4±0.7, P<.0001)。关于术后生活质量,根据卡片问卷结果显示,50%的患者在术后未接受抗过敏治疗。

结论

我们的结果表明,下鼻甲黏膜下切除术是长期管理鼻部过敏反应的有效策略,并有助于改善生活质量。

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