鼻内镜下翼管神经联合筛前神经切断术治疗变应性鼻炎合并鼻息肉的临床疗效

Clinical effect of endoscopic pterygoid nerve combined with anterior ethmoidal nerve blockade in treatment of allergic rhinitis complicated with nasal polyp

摘要:

目的 探讨鼻内镜下翼管神经联合筛前神经切断术治疗变应性鼻炎合并鼻息肉的临床疗效。方法 选择该院耳鼻咽喉头颈外科收治的变应性鼻炎合并鼻息肉患者108例，随机分为两组，各54例。对照组行常规鼻内镜下鼻窦手术，观察组行常规鼻内镜下鼻窦手术联合翼管神经和筛前神经切断术，对比两组患者治疗前、治疗后1周、2周、3周、3个月、6个月和1年的鼻腔疼痛视觉模拟评分法（VAS）、鼻结膜炎生存质量量表（RQLQ）评分、哮喘生存质量量表（AQLQ）评分、治疗总有效率和并发症发生率。结果 观察组治疗总有效率为98.15%，高于对照组的85.19%，差异有统计学意义（P < 0.05）；治疗前，两组患者鼻腔阻力（NR）、鼻黏膜纤毛输送率（MTR）、鼻黏膜纤毛传输时间（MTT）和Lund—Kennedy评分比较，差异均无统计学意义（P > 0.05）；两组患者治疗后MTR明显高于治疗前，且观察组高于对照组，差异均有统计学意义（P < 0.05）；两组患者治疗后NR小于治疗前，且观察组小于对照组，MTT短于治疗前，且观察组短于对照组，Lund—Kennedy评分低于治疗前，且观察组低于对照组，差异均有统计学意义（P < 0.05）；治疗前，两组患者鼻腔疼痛VAS、RQLQ评分和AQLQ评分比较，差异均无统计学意义（P > 0.05）；治疗后1周、2周、3周、3个月、6个月和1年，观察组鼻腔疼痛VAS明显低于对照组，观察组RQLQ评分明显低于对照组，AQLQ评分明显高于对照组，差异均有统计学意义（P < 0.05）；观察组并发症发生率明显低于对照组，差异有统计学意义（P < 0.05）。结论 鼻内镜下翼管神经联合筛前神经切断术治疗变应性鼻炎合并鼻息肉，效果明显，不仅可有效地缓解患者鼻腔疼痛，还能提高术后生存质量，减少术后并发症，具有临床应用价值。

Abstract:

Objective To investigate the clinical efficacy of endoscopic pterygoid nerve combined with anterior ethmoidal nerve transection in treatment of allergic rhinitis with nasal polyps.Method A clinical practice study was conducted on 108 patients with allergic rhinitis complicated with nasal polyps. After enrollment, they were randomly divided into two groups, 54 cases were included in the control group and treated with conventional endoscopic sinus surgery, while 54 cases were included in the observation group and treated with conventional endoscopic sinus surgery combined with pterygoid nerve and ethmoidal nerve transection. The nasal pain visual analogue scale (VAS), rhinoconjunctivitis quality of life questionnaire (RQLQ), asthma quality of life questionnaire (AQLQ), total effective rate, and complication rate of the two groups were compared before treatment and 1 week, 2 weeks, 3 weeks, 3 months, 6 months, and 1 year after treatment.Result Compared with the control group, the total effective rate of treatment was 98.15% in the observation group, which was higher than 85.19% in the control group, the difference was statistically significant (P < 0.05). Before treatment, there were no significant differences in nasal resistance (NR), mucociliary transport rate (MTR), mucociliary transport time (MTT), and Lund-Kennedy scores between the two groups, the differences were no statistically significant (P > 0.05). After treatment, MTR in two groups increased compared with before treatment, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05); NR, MTT, and Lund-Kennedy scores in two groups decreased, and the observation group was lower than the control group, the differences were statistically significant (P < 0.05). Before treatment, there were no significant differences in nasal pain VAS, RQLQ, and AQLQ between the two groups, the differences were no statistically significant (P > 0.05). After treatment, at 1 week, 2 weeks, 3 weeks, and 3 months, 6 months, and 1 year, the observation group had lower nasal pain VAS compared to the control group, while the observation group had lower RQLQ and higher AQLQ compared to the control group, the differences were statistically significant (P < 0.05). The incidence of complications in the observation group was lower than the control group, the difference was statistically significant (P < 0.05).Conclusion The clinical efficacy of endoscopic pterygoid nerve combined with ethmoidal nerve transection for the treatment of allergic rhinitis complicated with nasal polyps is significant. It can not only effectively alleviate nasal pain in patients, but also improve their quality of life and reduce postoperative complications, which has clinical application value.