高剂量的 HIFU 治疗可能会导致中重度常年性变应性鼻炎的疗效更高、持续时间更长。
Higher dosage of HIFU treatment may lead to higher and longer efficacy for moderate to severe perennial allergic rhinitis.
机构信息
1. Department of Otolaryngology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China.
出版信息
Int J Med Sci. 2013 Nov 27;10(13):1914-20. doi: 10.7150/ijms.7117. eCollection 2013.
OBJECTIVES
This study was to compare the efficacies and side effects of high intensity focused ultrasound (HIFU) treatment for perennial allergic rhinitis (PAR) with regular and increased dosage.
STUDY DESIGN
A prospectively assembled cohort was retrospectively analyzed through visual analogue scale (VAS).
METHODS
Regular dosage of HIFU treatment was applied to 56 PAR patients in group A. An increased dosage as twice as the regular one was applied to 48 patients in group B. Nasal obstruction, sneezing, rhinorrhea and rhinocnesmus, which were recognized as the four main symptoms of allergic rhinitis (AR), were evaluated before treatment, 3 months after treatment, and 1 year after treatment. The satisfaction of patients was also evaluated at 1 year postoperatively. Biopsy of the inferior turbinate and morphometric analysis were applied to 11 patients in group A and 10 in group B before HIFU treatment and 3 months after treatment.
RESULTS
Comparing the AR symptoms before treatment, There is no statistical difference observed between group A and B (p>0.05). The four main symptoms at 3 months and 1 year after treatment were all significantly improved (p<0.01) in both group A and B. The VAS scores of AR symptoms in Group B were lower than those in Group A at the same stage after treatment, especially at 1 year after treatment (p<0.05). Comparing the results at 3 months and 1 year after treatment, a tendency of recurrence of these symptoms was observed statistically in group A (p<0.05), but not in group B (p>0.05). More cases of nasal dryness and perirhinal swelling were found in group B than those in group A (p<0.05), while all side effects were mild and temporary. Patients in group B were more satisfied than those in group A (p=0.0866 >0.05), though not statistically significant. More reduction of the eosinophils, other inflammatory cells, and the submucosal glands was observed after HIFU treatment in group B than that in group A (p<0.05).
CONCLUSIONS
A proper increment of HIFU dosage may be recommended to meet the needs of more improvement of AR symptoms and less recurrence.
目的
本研究旨在比较高强度聚焦超声（HIFU）治疗常年性变应性鼻炎（PAR）的疗效和副作用，比较常规剂量和增加剂量的疗效。
设计
通过视觉模拟量表（VAS）对前瞻性采集的队列进行回顾性分析。
方法
A 组 56 例 PAR 患者采用常规剂量 HIFU 治疗，B 组 48 例患者采用常规剂量的两倍剂量 HIFU 治疗。治疗前、治疗后 3 个月和治疗后 1 年评估鼻塞、打喷嚏、流涕和鼻后滴注，以及患者的满意度。A 组和 B 组各有 11 例和 10 例患者在 HIFU 治疗前和治疗后 3 个月进行下鼻甲活检和形态计量分析。
结果
治疗前两组 AR 症状比较，差异无统计学意义（p>0.05）。两组治疗后 3 个月和 1 年的四项主要症状均明显改善（p<0.01）。治疗后同阶段 B 组 AR 症状 VAS 评分低于 A 组，尤其是治疗后 1 年（p<0.05）。比较治疗后 3 个月和 1 年的结果，A 组这些症状有复发趋势，差异有统计学意义（p<0.05），B 组无复发（p>0.05）。B 组较 A 组出现鼻腔干燥和眶周肿胀的病例较多（p<0.05），但所有不良反应均为轻度和暂时性的。B 组患者的满意度高于 A 组（p=0.0866 >0.05），但差异无统计学意义。B 组 HIFU 治疗后，嗜酸性粒细胞、其他炎症细胞和黏膜下腺体的减少较 A 组更为明显（p<0.05）。
结论
适当增加 HIFU 剂量可能更有助于改善 AR 症状和减少复发。
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