鼻内镜下低温等离子刀鼻后神经切断术与鼻内镜下鼻后神经切断术对中重度变应性鼻炎的近远期疗效及安全性分析

摘要 目的：探讨鼻内镜下低温等离子刀鼻后神经切断术与鼻内镜下鼻后神经切断术对中重度变应性鼻炎的近远期疗效及安全性。方法：选择2019年3月到2021年3月来我院诊治的变应性鼻炎患者90例，将其随机分为对照组与观察组，对照组中48例，观察组42例，对照组给予鼻内镜下鼻后神经切断术治疗，观察组给予鼻内镜下低温等离子刀鼻后神经切断术治疗。对比两组患者术前、术后3个月及术后1年的喷嚏、鼻塞、鼻痒、流涕临床症状评分、临床疗效、生活质量评分、血清血管活性肠肽5水平，对比两组并发症发生率。结果：术后3个月及术后1年，两组临床症状评分降低，且观察组较对照组低（P<0.05）；术后3个月，两组的临床症状评分低于同组间术后1年，但对比无差异（P>0.05）。术后3个月及术后1年，观察组的治疗有效率均较高（P<0.05）。术后3个月及术后1年，两组生活质量评分降低，且观察组较对照组低（P<0.05）；术后3个月，两组的生活质量评分高于同组间术后1年，但对比无差异（P>0.05）。术后3个月及术后1年，两组血清血管活性肠肽5水平降低，且观察组较对照组低（P<0.05）；术后3个月，两组的血清血管活性肠肽5水平低于同组间术后1年，但对比无差异（P>0.05）。观察组的并发症发生率较对照组低（P<0.05）。结论：与鼻内镜下鼻后神经切断术相比，鼻内镜下低温等离子刀鼻后神经切断术可提高中重度变应性鼻炎的近远期疗效，且安全性较好。

Short-term and Long-term Efficacy and Safety of Endoscopic Low-temperature Plasma Retronasal Neurotomy and Endoscopic Retronasal Neurotomy for Moderate to Severe Allergic Rhinitis

ABSTRACT Objective: To investigate the short-term and long-term efficacy and safety of endoscopic low-temperature plasma retronasal neurotomy and endoscopic retronasal neurotomy in treatment of moderate to severe allergic rhinitis. Methods: 90 patients with allergic rhinitis treated in our hospital from March 2019 to March 2021 were selected. 90 patients were randomly divided into the Matched group and the observation group, 48 cases in the Matched group and 42 cases in the observation group. The Matched group were treated with nasal endoscopic retronasal neurotomy. The observation group were treated with retronasal neurotomy with low temperature plasma knife under nasal endoscope. The clinical symptom scores of sneezing, nasal congestion, nasal itching, runny nose, clinical efficacy, quality of life score, serum vasoactive intestinal peptide-5 level before operation were compared between the two groups afer operation for 3 months and 1 year, and the complications incidence was compared in two groups. Results: At 3 months and 1 year after operation, the clinical symptom scores of the two groups decreased, and the observation group was lower than the matched group (P<0.05). At 3 months after operation, the clinical symptom scores of the two groups were lower than those of the same group after operation 1 year, but there was no difference in comparison (P>0.05). 3 months after operation and 1 year after operation, the treatment effective rate of the observation group was higher (P<0.05). At 3 months and 1 year after operation, the quality of life scores of the two groups decreased, and the observation group was lower than the Matched group (P<0.05). At 3 months after operation, the quality of life scores of the two groups were higher than those of the same group 1 year, but there was no difference in comparison (P>0.05). At 3 months and 1 year after operation, the levels of serum vasoactive intestinal peptide 5 in the two groups decreased, and the observation group was lower than the matched group(P<0.05). The level was lower than that of the same group at 1 year after operation, but there was no difference (P>0.05). The incidence of complications in the observation group was lower than that in the matched group (P<0.05). Conclusion: Compared with endoscopic retronasal neurotomy, endoscopic retronasal neurotomy with low-temperature plasma knife can improve the short-term and long-term efficacy of moderate to severe allergic rhinitis, and which had better safety.