Analysis of clinical effect of unilateral vidian neurectomy following endoscopic trans-sphenoethmoidal recess approach for allergic rhinitis treatment
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摘要: 目的: 探讨鼻内镜下经蝶筛隐窝单侧翼管神经切断术治疗变应性鼻炎(AR)的临床疗效。方法: 回顾性分析接受鼻内镜下经蝶筛隐窝单侧翼管神经切断术的80例中-重度AR患者的临床资料,应用视觉模拟量表(VAS)进行鼻部症状(鼻痒、喷嚏、清涕、鼻塞)和总体症状评分,术侧与对侧评分配对t检验;随访满3年的24例患者多组间均数比较采用方差分析,进一步两两比较采用LSD-t检验。结果: 80例患者随访满1年,51例患者随访满2年,24例患者随访满3年,对术前和术后1、2、3年的4个不同时间点的鼻部症状(鼻痒、喷嚏、清涕、鼻塞)和总体症状评分,术侧和对侧比较差异无统计学意义(P>0.05);随访满3年的24例患者,对术前和术后1、2、3年4个时间点鼻部症状和总体症状评分差异有统计学意义(P<0.05)。LSD两两比较结果显示,术后3个时间点分别与术前比较差异均有统计学意义(P<0.01)。结论: 鼻内镜下经蝶筛隐窝单侧翼管神经切断术是一种治疗中-重度AR的安全、有效的方法,且为单侧手术,双侧有效。Abstract: Objective: To explore the clinical efficacy of unilateral vidian neurectomy following endoscopic trans-sphenoethmoidal recess approach in treating allergic rhinitis.Method: The clinical data of 80 patients with moderate-severe allergic rhinitis who underwent unilateral vidian neurectomy following endoscopic trans-sphenoethmoidal recess approach were reviewed retrospectively. Visual analogue scale(VAS) was used to assess total symptom scores and nasal symptoms including nasal itching, nasal sneezing, rhinorrhea and nasal congestion. The paired T test was used to compare the scores between surgical side and control side.Twenty-four patients with 3 years of follow-up were assessed by analysis of variance with comparison of means between multiple groups. Further comparison between any two means was performed by LSD-t test.Result: A total of 80 patients were followed-up for one year, with 51 patients for two years and 24 patients for three years. Among 24 patients, total symptom scores and nasal symptoms (nasal itching, nasal sneezing, rhinorrhea and nasal congestion) at pre-operation, 1 year,2 year and 3 year after operation were compared between surgical side and control side. There was no significant difference by the paired T test(P>0.05),but there was statically significant by analysis of variance(P<0.05).The analysis of LSD-t test showed significant differences between pre-operative time point and each of the three time points after operation (P<0.05).Conclusion: The unilateral vidian neurectomy following endoscopic trans-sphenoethmoidal recess approach is an safe and effective technique in the management of moderate-severe allergic rhinitis, and unilateral surgery could relieve bilateral nasal symptoms.
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Key words:
- allergic rhinitis /
- endoscope /
- transsphenoethmoidal recess /
- vidian neurectomy /
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