山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (5): 78-81.doi: 10.6040/j.issn.1673-3770.0.2017.219

• ·论著· • 上一篇    下一篇

鼻内镜下等离子射频消融术对合并鼻窦炎的小儿腺样体肥大患者疗效及鼻腔黏膜纤毛清除功能的影响

王驰,刘星,孔磊,洪兴和,宁博   

  1. 徐州市中心医院耳鼻咽喉头颈外科, 江苏 徐州 221009
  • 收稿日期:2017-05-19 出版日期:2018-09-20 发布日期:2018-09-20

Clinical efficacy of endoscopic plasma radiofrequency ablation in the treatment of adenoid hypertrophy and sinusitis in children and its effect on nasal mucociliary clearance

WANG Chi, LIU Xing, KONG Lei, HONG Xinghe, NING Bo   

  1. Department of Otorhinolaryngology Head and Neck Surgery, The Central Hospital of Xuzhou, Xuzhou 221009, Jiangsu, China
  • Received:2017-05-19 Online:2018-09-20 Published:2018-09-20

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摘要： 目的 探讨鼻内镜下等离子射频消融术治疗小儿腺样体肥大并鼻窦炎的临床疗效及对鼻腔黏膜纤毛清除功能的影响。 方法 选取腺样体肥大并鼻窦炎患儿96例,随机平均分为两组,对照组采用普通手术切除法,观察组采用低温等离子射频消融法,对比两组患者的手术时间、术中出血量、鼻内镜下评分下降幅值,采用糖精试验测定手术前后鼻腔黏膜纤毛传输速率(MTR)。 结果 两组患者的临床疗效比较差异无统计学意义(P>0.05)。两组患者的手术时间、术中出血量及鼻内镜下评分下降幅值比较,差异有统计学意义(P<0.05)。与手术前比较,对照组患者手术后MTR差异无统计学意义(P>0.05),观察组患者手术后MTR差异有统计学意义(P<0.05);与治疗组比较,观察组患者手术后MTR差异有统计学意义(P<0.05)。 结论 鼻内镜下等离子射频消融术治疗小儿腺体肥大并鼻窦炎的术中出血量少、手术时间短且对患者鼻腔黏膜纤毛清除功能影响不明显,临床疗效显著。

关键词: 腺样体肥大, 鼻窦炎, 鼻黏膜, 射频消融术, 纤毛

Abstract: Objective To investigate the clinical efficacy of endoscopic plasma radiofrequency ablation in the treatment of adenoid hypertrophy and sinusitis in children and its effect on nasal mucociliary clearance. Methods Ninety-six children with adenoid hypertrophy and sinusitis were randomly divided into two groups: the control group, in which the children were treated with conventional surgical resection, and the observation group, in which the children were treated with low-temperature plasma radiofrequency ablation. The operative time, intraoperative blood loss, and nasal endoscopic score were compared between the two groups. The nasal mucociliary transmission rate(MTR)was measured using the saccharin test before and after surgery. Results There was no difference between the two groups in clinical efficacy(P>0.05); differences in the operative time, intraoperative blood loss, and reduced amplitude of endoscopic score were statistically significant(P<0.05)between the two groups. In the control group, the MTR after treatment was significantly different from that before treatment(P<0.05); however, no significant difference was observed in the observation group(P>0.05). and there was a significant difference in the MTR after operation in the observation group(P<0.05). Conclusion Endoscopic plasma radiofrequency ablation is clinically effective for the treatment of glandular hypertrophy and sinusitis in children, and is associated with less intraoperative blood loss, shorter operative times, and no significant effect on nasal mucociliary clearance.

Key words: Sinusitis, Nasal mucosa, Cilia, Radiofrequency ablation, Adenoid hypertrophy

中图分类号: 

  • R729
[1] 高惠萍, 庞敏飞. 腺样体肥大儿童合并慢性鼻窦炎的临床调查及相关性分析[J]. 中国耳鼻咽喉头颈外科, 2015, 22(2):89-91. GAO Huiping, PANG Minfei. Clinical investigation and correlation analysis of adenoid hypertrophy with chronic sinusitis in children[J]. Chin Arch Otolaryngol Head Neck Surg, 2015, 22(2):89-91.
[2] Szöke H, Maródi M, Sallay Z, et al. Integrative versus conventional therapy of chronic otitis media with effusion and adenoid hypertrophy in children: a prospective observational study[J]. Forschende Komplementarmedizin, 2016, 23(4):231.
[3] 常昆鹏, 曹华. 不同手术方式治疗儿童腺样体肥大的临床疗效分析[J]. 河南医学研究, 2014, 23(2):56-59.
[4] 中华耳鼻咽喉头颈外科杂志编委会. 慢性鼻-鼻窦炎诊断和治疗指南[J]. 中华医学信息导报, 2009, 38(8):21-22.
[5] 付誉, 王吉喆, 李瀛. 腺样体切除术对儿童慢性鼻窦炎疗效的影响[J]. 大连医科大学学报, 2014, 36(3):258-261. FU Yu, WANG jizhe, LI Ying. Treatment effect of adenoidectomy on chronic sinusitis in children[J]. Journal of Dalian Medical Yniversity, 2014, 36(3):258-261.
[6] 刘悄吟, 倪鑫. 细菌感染与儿童腺样体肥大及其相关疾病[J]. 国际耳鼻咽喉头颈外科杂志, 2015, 39(5):296-299.
[7] 杨羿容, 张恒, 鄢斌成. 腺样体切除术对儿童鼻窦炎转归的影响[J]. 泸州医学院学报, 2014, 37(6):597-599. YANG Yirong, ZHANG Heng, YAN Bincheng. Impact of adenoidectomy on outcomes of childrens rhinosinusitis[J]. Journal of Luzhou Medical College, 2014, 37(6):597-599.
[8] Anand V, Sarin V, Singh B. Changing Trends in Adenoidectomy[J]. Indian Journal of Otolaryngology and Head & Neck Surgery, 2014, 66(4):1-6.
[9] 顾健伟, 邰隽, 郭永丽,等. 鼻内镜辅助下腺样体切除术与传统腺样体刮除术对腺样体增生治疗效果比较的Meta分析[J]. 中国耳鼻咽喉头颈外科, 2014, 21(9):465-472. GU Jianwei, TAI Jun, GUO Yongli, et al. Comparison the effect of endoscopic-assisted transoral adenoidectomy and traditional transoral curette adenoidectomy on the treatment of adenoid hypertrophy: a meta-analysis[J]. Chin Arch Otolaryngol Head Neck Surg, 2014, 21(9):465-472.
[10] 伍立德, 谭学君, 文溢,等. 4种手术治疗腺样体肥大的效果研究[J]. 重庆医学, 2016, 45(27):3808-3810. WU Lide, TAN Xuejun, WEN Yi, et al. Four types of surgery for the treatment of asenoid hypertrophy[J]. Chongqing Medical, 2016, 45(27):3808-3810.
[11] 彭正加, 刘彬, 廖俊,等. 经等离子刀治疗小儿腺样体肥大并鼻窦炎的临床疗效观察[J]. 中国耳鼻咽喉颅底外科杂志, 2015, 21(4):334-336.
[12] 毛敏, 张建国, 陶爱林,等. 腺样体切除术对鼻腔黏膜纤毛清除功能的影响[J]. 中国耳鼻咽喉颅底外科杂志, 2016, 22(1):50-53. MAO Min, ZHANG Jianguo, TAO Ailin, et al. Effect of adenoidectomy on nasal mucociliary clearance in children[J]. Chin J Otorhinolaryngol Skull Base Surg, 2016, 22(1):50-53.
[13] 朱恒才, 程雷, 史祥伟,等. 腺样体肥大融切术后对儿童鼻窦炎治疗转归的影响[J]. 中国中西医结合耳鼻咽喉科杂志, 2014, 22(1):43-46.
[14] 黄杰, 陈丽, 高莉莉,等. 下鼻甲外移联合低温等离子消融术治疗慢性肥厚性鼻炎疗效分析[J]. 中国中西医结合耳鼻咽喉科杂志, 2014, 22(3):175-178. HUANG Jie, CHEN Li, GAO Lili, et al. Effect of interior turbinate outfracture combined with low-temperature plasma radiofrequency ablation on chronic rhinitis[J]. Chin J Otorhinolaryngol Integ Med, 2014, 22(3):175-178.
[15] 邹坚定, 胡志孟, 潘叶挺,等. 下鼻甲等离子消融术对鼻黏膜组织学及纤毛功能改变的初步研究[J]. 中国耳鼻咽喉头颈外科, 2012, 19(4):200-202. ZOU Jianding, HU Zhimeng, PAN Yeting, et al. Clinical research of the influence of coblation inferior turbinate reduction on nasal mucosa and cilia function[J]. Chin Arch Otolaryngol Head Neck Surg, 2012, 19(4):200-202.
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