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经三点一侧等离子鼻甲消融术治疗下鼻甲肥大。

Treatment of inferior turbinate hypertrophy by plasma turbinate reduction with onepointthreeside way.

机构信息

Outpatient Comprehensive Treatment Room, Third Xiangya Hospital, Central South University, Changsha 410013.

Department of Otolaryngology, Third Xiangya Hospital, Central South University, Changsha 410013.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Jul 28;47(7):895-901. doi: 10.11817/j.issn.1672-7347.2022.220058.

Abstract

OBJECTIVES

Nasal congestion is often the main symptom of the patients with non-allergic rhinitis, who have inferior turbinate hypertrophy if getting poor treatment effect. Plasma treatment for inferior turbinate hypertrophy can effectively improve nasal obstruction. Generally, plasma treatment with multiple puncture sites, makes patients intraoperative painful and postoperative bleeding, which let patients often fear of surgery. Postoperative nasal adhesion or lower turbinate scar and other complications sometimes happened, and some patients still feel nasal obstruction due to severe mucosal damage and scar formation. We innovatively used one-point-three-side plasma turbinate volume reduction in the treatment of inferior turbinate hypertrophy, in order to reduce complication, improve symptoms, and enhance curative effect.

METHODS

A total of 111 patients with non-allergic rhinitis with complete data due to hypertrophy of inferior turbinate and poor drug treatment from Nov. 2011 to Oct. 2019. The hypertrophic inferior turbinate of patients with non-allergic rhinitis was ablated by plasma turbinate volume reduction, and the symptom scores of patients were evaluated by visual analog scales (VAS) before surgery, 1 week, 1 month, 3 months, and 6 months after surgery. The intraoperative pain was scored by VAS. The pathological morphology of nasal mucosa was observed before and after operation in some patients.

RESULTS

The nasal obstruction score of the patients was significantly lower at 1 week, 1 month, 3 months and 6 months after the operation (all <0.05). The distribution of submucosal blood vessels and glands was improved by postoperative pathological observation.

CONCLUSIONS

Plasma turbinate volume reduction with one-point-three-side is effective with minimally invasion, and less complication, which is worthy of clinical promotion.

摘要

目的

对于非变应性鼻炎患者,如果治疗效果不佳,常以下鼻甲肥大作为主要症状,等离子治疗下鼻甲肥大可有效改善鼻塞。通常情况下,等离子下鼻甲多部位打孔,术中疼痛明显,术后出血多,患者往往对手术心存恐惧。术后鼻腔粘连或下鼻甲疤痕等并发症时有发生,部分患者因黏膜损伤严重、疤痕形成,仍感鼻塞。我们创新性地采用 1 点 3 边等离子下鼻甲体积缩小术治疗下鼻甲肥大,以减少并发症,改善症状,提高疗效。

方法

收集 2011 年 11 月至 2019 年 10 月因下鼻甲肥大且药物治疗效果不佳的非变应性鼻炎患者 111 例,采用等离子下鼻甲体积缩小术消融非变应性鼻炎患者的肥大下鼻甲,采用视觉模拟评分法(VAS)评估患者术前、术后 1 周、1 个月、3 个月、6 个月的症状评分,采用 VAS 评分评估术中疼痛,部分患者术前、术后行鼻黏膜病理形态学观察。

结果

患者术后鼻塞评分在术后 1 周、1 个月、3 个月、6 个月时均显著降低(均<0.05),术后病理观察下鼻甲黏膜下血管和腺体分布改善。

结论

1 点 3 边等离子下鼻甲体积缩小术微创、并发症少,效果确切,值得临床推广。

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本文引用的文献

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Types of rhinitis.鼻炎的类型。
Otolaryngol Clin North Am. 2011 Jun;44(3):549-59, vii. doi: 10.1016/j.otc.2011.03.016. Epub 2011 Apr 29.

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