两种不同术式治疗变应性鼻炎合并鼻中隔偏曲的-第三军医大学学报.doc

两种手术方法治疗伴鼻中隔偏曲的变应性鼻炎的疗效分析 赵玉林 李伟亚 王静 张亚倩 齐景翠 （郑州大学第一附属医院鼻科，河南郑州，450052） 【摘要】 目的 观察并分析两种手术方法治疗伴鼻中隔偏曲的变应性鼻炎的疗效及应用价值。 方法 将91例合并鼻中隔偏曲的变应性患者根据下鼻甲粘膜肥厚及骨增生情况分为两组，分别行鼻中隔偏曲矫正联合双下鼻甲低温等离子射频消融并骨折外移术、鼻中隔偏曲矫正联合双下鼻甲骨黏膜下部分切除术，疗效采用2004兰州标准和鼻阻力测量值进行评价。 结果 患者术后随访1年，鼻阻力较术前明显改善，两组症状改善的总有效率均大于88%。 结论 两种不同手术方法均显著降低了患者的鼻阻力，改善了过敏性症状，取得了良好效果。 【关键词】变应性鼻炎；鼻中隔偏曲；等离子消融；下鼻甲骨黏膜下切除术 The effect of two surgical treatments in treatment of allergic rhiniti complicated with nasal septum deviation ZHAO Yulin LI Weiya WAN Jing ZHANG Yaqian QI Jingcui ( Department of Ｒhinology，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052， China) [Abstract] Objective To evaluate the effect of two surgical treatments in treatment of allergic rhiniti complicated with nasal septum deviation. Methods 91 cases of allergic rhiniti complicated with nasal septum deviation were divided into 2 groups according to the inferior turbinate mucosal hypertrophy and hyperplasia of bone. They were treated by resection of nasal septum deviation combined with temperature-controlled radio-frequency, or combined with partial submucoperiosteous resection of inferior turbinate bone. The Lanzhou standard(2004) and nasal airway resistance were used to evaluate the efficacy. Result After followed-up for one year postoperatively, the nasal resistance was significantly decreased and the effective rates were greater than 88% in each group. Conclusion Both of the two surgical treatments can significantly depress the nasal resistance, and improve the allergic symptoms, shows good effect. [Key words] Allergic rhinitis; Deviaction of nasal septum; Temperatur-controlled radio-frequency; Partial submucoperiosteous resection of inferior turbinate bone. 变应性鼻炎（allergic rhinitis，AR），可严重影响患者的生活质量，并可诱发支气管哮喘，与鼻窦炎、鼻息肉等疾病也有密切关系。AR的发病率目前有全球逐年增加的趋势，已成为耳鼻喉科门诊最常见的疾病之一，其治疗原则包括环境控制、药物治疗、免疫治疗和手术疗法等[1]。虽然手术不是AR的主要治疗手段，但目前已经认识到鼻腔解剖结构的异常与AR症状的严重程度及治疗效果有一定相关性，在临床中我们也发现合并鼻中隔偏曲的AR患者症状通常较严重、单纯药物治疗效果欠