鼻内镜下低温等离子术切除鼻前庭囊肿的临床疗效研究

Effect of nasal endoscopic cryoplasma on reducing trauma and inflammatory factors in nasal vestibular cyst

摘要:

研究应用鼻内镜下低温等离子术治疗鼻前庭囊肿的临床效果。方法 选择该院2014年1月－2018年1月收治的60例鼻前庭囊肿患者为研究对象，按照随机数字表法分成对照组和研究组，每组30例。对照组给予传统唇龈沟切口进路切除囊肿，研究组给予鼻内镜下低温等离子术切除囊肿，对比两组患者手术指标、术后肿胀、疼痛程度、炎症因子和并发症等情况。结果 研究组手术时间、术中出血量、术后伤口愈合时间及上皮化时间均明显优于对照组，差异有统计学意义（P <0.05）；术后中度、重度肿胀和伤口中度、重度疼痛倒数均明显低于对照组，差异有统计学意义（P <0.05）；术后5 d炎症因子水平比较，研究组肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和C-反应蛋白（CRP）水平均明显低于对照组，差异有统计学意义（P <0.05）；研究组术区感染、麻木和鼻前庭不适等总发生率以及术后6个月复发率均明显低于对照组，差异有统计学意义（P <0.05）。结论 与传统唇龈沟切口进路切除囊肿相比，鼻内镜下低温等离子术治疗鼻前庭囊肿对患者创伤更小，有助于促进伤口愈合、缓解术后肿胀，还能减轻疼痛，术后炎症反应轻，并发症及复发率较低，值得临床推广应用。

Abstract:

To study the clinical effect of nasal endoscopic cystic surgery with nasal endoscopic cryoplasma. Methods 60 patients with nasal vestibular cysts from January 2014 to January 2018 were enrolled as study subjects. They were divided into control group and study group randomly 30 cases in each. The control group received a conventional cleft lip and incision approach to remove cysts. The study group underwent endoscopic cryo-plasma resection for cysts. The surgical parameters, postoperative swelling, pain, inflammatory factors, complications, etc. were compared between the two groups. Results The study showed that the operation time, intraoperative blood loss, postoperative wound healing time and epithelialization time of the study group were significantly better than that in control group, the difference was statistically significant (P < 0.05); Moderate and severe swelling after surgery, moderate and severe pain of wound in study group were significantly lower than that of the control group, and the difference was significant (P < 0.05). Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP) levels in study group at 5 day after surgery were significantly lower than the control group, and the difference was statistically significant (P < 0.05); The overall incidence of infection, numbness, nasal vestibular discomfort and recurrence rate at 6 months after surgery in study group were significantly lower than the control group, and the difference was statistically significant (P < 0.05). Conclusion Endoscopic low-temperature plasma surgery compared with traditional cleft lip incision approach for cystectomy for nasal vestibular cysts has less trauma to the patient, helps promote wound healing, reduces postoperative swelling and pain, and has low postoperative inflammatory response. The complications and recurrence rate are low, which is worthy of clinical application.