本文選題：鼻內(nèi)鏡 + 二線減張法�。� 參考：《中國老年學雜志》2015年19期

【摘要】：目的探討鼻內(nèi)鏡下二線減張法鼻中隔矯正術對變異性鼻炎伴鼻中隔偏曲患者療效和血清炎性因子水平的影響。方法隨機選取2013年5月至2014年5月該院行鼻內(nèi)鏡下二線減張法鼻中隔矯正術治療的伴鼻中隔偏曲的變異性鼻炎患者126例作為觀察組,另選取30例同期行鼻內(nèi)鏡下三線減張法鼻中隔成形術治療的伴鼻中隔偏曲的變異性鼻炎患者作為對照組。兩組均接受相應的手術治療且術后均計劃隨訪1年。于治療結束時統(tǒng)計兩組療效和并發(fā)癥發(fā)生情況。分別于術前(T0)及術后1 d(T1)、1 w(T2)、1個月(T3)、3個月(T4)、6個月(T5)和1年(T6)時檢測患者自覺鼻塞程度視覺模擬評分法(VAS)得分,采用酶聯(lián)免疫吸附(ELISA)法檢測同期血清腫瘤壞死因子(TNF)-α、白介素(IL)-4、IL-6等炎癥因子水平。結果觀察組療效顯著者比例高于對照組,治療無效者比例低于對照組(P0.05)。觀察組VAS評分和血清TNF-α、IL-4和IL-6水平均呈先升高后下降趨勢且均于T1達到最高點,并于T6達到最低點。對照組VAS評分和血清TNF-α、IL-4和IL-6水平亦呈先升高后下降趨勢,于T2達到最高點,并于T6達到最低點。觀察組T2、T3、T4、T5、T6的VAS評分和血清TNF-α、IL-4和IL-6水平均低于對照組(P0.05)。觀察組和對照組鼻中隔穿孔、鼻中隔血腫、鼻梁塌陷等并發(fā)癥發(fā)生率比較差異無統(tǒng)計學意義(P0.05)。結論鼻內(nèi)鏡下二線減張法鼻中隔矯正術治療伴鼻中隔偏曲的變異性鼻炎療效顯著,在有效緩解患者的臨床癥狀和控制患者炎癥的基礎上并不會增加并發(fā)癥的發(fā)生,具有良好的安全性和可行性,值得臨床推廣使用。
[Abstract]:Objective to investigate the effect of nasal septum correction with second line reduction of Zhang Fa under nasal endoscope on patients with septum deviation and the level of serum inflammatory factors. Methods from May 2013 to May 2014, 126 patients with nasal septum deviation treated by endoscopic second line subtraction Zhang Fa correction were randomly selected as the observation group. Another 30 patients with nasal septal deviation treated by endoscopic triple line subtraction nasoplasty (Zhang Fa) were selected as control group. Both groups received corresponding surgical treatment and planned to follow up for 1 year. At the end of the treatment, the curative effect and complications of the two groups were counted. The VASs were measured before operation (T0) and 1 day after operation (1 week after operation, 1 month after T3, 3 months with T4, 6 months with T5) and 1 year with T6). The serum levels of TNF- 偽, IL-4 and IL-6 in serum were measured by enzyme linked immunosorbent assay (Elisa). Results the proportion of patients with significant curative effect in the observation group was higher than that in the control group, and the rate of ineffective treatment was lower than that of the control group (P 0.05). The VAS score, serum TNF- 偽 IL-4 and IL-6 levels in the observation group increased first and then decreased, and reached the highest point at T1 and reached the lowest point at T6. In the control group, the VAS score, serum TNF- 偽 IL-4 and IL-6 levels increased first and then decreased, reaching the highest point at T2 and the lowest at T6. The VAS scores and serum TNF- 偽 -IL-4 and IL-6 levels in the observation group were lower than those in the control group (P 0.05). There was no significant difference between the observation group and the control group in the incidence of complications such as perforation of nasal septum, hematoma of nasal septum and collapse of nasal bridge. Conclusion the treatment of nasal septum with deviation of nasal septum by two-line subtraction Zhang Fa under nasal endoscope is effective and effective in relieving the clinical symptoms and controlling the inflammation of the patients, and does not increase the incidence of complications. It has good safety and feasibility and is worth popularizing in clinic.
【作者單位】： 上饒市人民醫(yī)院耳鼻喉科;
【分類號】：R765.9

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