鼻内镜下鼻后神经切断术对变应性鼻炎患者心理状态的影响

Effect of endoscopic retronasal neurotomy on psychological state of patients with allergic rhinitis

摘要:

目的 探讨鼻内镜下鼻后神经切断术对中-重度持续性变应性鼻炎（AR）患者心理状态的影响。方法 选取2022年－2023年于该院变态反应门诊就诊的中-重度持续性AR患者100例，采用鼻内镜下鼻后神经切断术+药物治疗的患者为实验组（50例），采用药物治疗的患者为对照组（50例）。分别于治疗前、治疗后6和12个月，采用鼻结膜炎相关生活质量量表（RQLQ）、焦虑自评量表（SAS）和抑郁自评量表（SDS）评估患者生活质量和心理状态。结果 治疗后6和12个月，实验组3种评分明显低于治疗前和同期对照组，差异均有统计学意义（P < 0.05），实验组治疗后12个月，SAS和SDS评分较治疗后6个月明显降低，差异均有统计学意义（P < 0.05）；对照组治疗后6个月，仅有RQLQ评分明显低于治疗前（P < 0.05），SAS和SDS评分与治疗前比较，差异均无统计学意义（P > 0.05），治疗后6个月与治疗后12个月各评分比较，差异均无统计学意义（P > 0.05）。结论 鼻内镜下鼻后神经切断术能明显提高中-重度持续性AR患者的生活质量，改善患者焦虑和抑郁的心理状态，该手术在鼻内镜下易定位，创伤小，视野清晰，且并发症少，经济有效，是较为安全的微创手术，值得临床推广应用。

Abstract:

Objective To explore the effect of nasal endoscopic retronasal neurotomy on the psychological status of patients with moderate-severe persistent allergic rhinitis (AR).Methods The enrolled subjects were patients with moderate to severe persistent AR from 2022 to 2023. Patients with endoscopic retronasal neurotomy plus drug therapy were selected as the experimental group and drug therapy as the control group. Rhinoconjunctivitis quality of life questionnaire (RQLQ), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the quality of life and psychological status before treatment, 6 months and 12 months after treatment, respectively.Results The three scores were significantly lower in the experimental group than those in the control group at 6 and 12 months after treatment, and the three scores were significantly lower at 6 and 12 months after treatment compared with those before treatment, the differences were statistically significant (P < 0.05), at 12 months after treatment, SAS and SDS in experimental group were significantly lower than those at 6 months after treatment, and both differences were statistically significant (P < 0.05). In the control group, 6 months after treatment, only the RQLQ scale was significantly lower than that before treatment (P < 0.05), SAS and SDS were not statistically significant when compared with those before treatment (P > 0.05), and there were no significant differences in these scores when comparing the scores at 6 months after treatment with those at 12 months after treatment (P > 0.05).Conclusion Endoscopic retronasal neurotomy can significantly improve the quality of life of patients with moderate to severe persistent AR, and further improve the psychological state of anxiety and depression of patients. This surgery is easy to locate under nasal endoscopy, with clear field of vision, less trauma, fewer complications, it is economic and effective, as a relatively safe minimally invasive surgery, and it is worthy of clinical application.