低温等离子技术辅助鼻内镜手术治疗慢性鼻窦炎伴鼻息肉的临床研究

doi:10.3969/j.issn.2095-378X.2021.04.004

外科研究与新技术 ›› 2021, Vol. 10 ›› Issue (4): 253-259.doi: 10.3969/j.issn.2095-378X.2021.04.004

低温等离子技术辅助鼻内镜手术治疗慢性鼻窦炎伴鼻息肉的临床研究

钱越¹, 戴复¹, 柳娴¹, 王粟¹, 金玲²

1.上海市嘉定区安亭医院耳鼻咽喉科头颈外科,上海 201805;
2.同济大学附属同济医院耳鼻咽喉头颈外科,上海 200065

收稿日期:2021-09-13 出版日期:2021-12-28 发布日期:2022-08-22
作者简介:钱越（1973—）,男,大学本科,副主任医师,从事耳鼻咽喉科临床工作;电子信箱：liebingzhijia@163.com
基金资助:
上海市嘉定区农业和社会事业科研项目（JDKW-2017-W22 ）

Clinical study of nasal endoscopic surgery using low-temperature plasma radiofrequency ablation for chronic rhinoinusitis with nasal polyps

QIAN Yue¹, DAI Fu¹, LIU Xian¹, WANG Su¹, JIN Ling²

1. Department of Otolaryngology, Head and Neck Surgery, Jiading District Anting Hospital, Shanghai 201805, China;
2. Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China

Received:2021-09-13 Online:2021-12-28 Published:2022-08-22

摘要/Abstract

摘要： 目的探讨低温等离子射频消融技术用于慢性鼻窦炎伴鼻息肉（chronic sinusitis with nasal polyps,CRSwNP）的手术治疗的可行性。方法选择2018年1月—2021年6月间48例符合入组标准的CRSwNP患者（试验组）行低温等离子射频消融技术辅助鼻内镜手术,与44例同期行功能性内镜鼻窦手术（functional endoscopic sinus surgery,FESS）的患者（对照组）进行各项指标对比,包括术中出血、术前术后的视觉模拟评分（visual analogue scale,VAS）、Lund-Kennedy总评分、Lund-Mackay评分及SNOT-20评分。结果两组术中出血量,试验组少于对照组（P<0.01）;术后3个月试验组VAS评分评分低于对照组（P<0.05）,差异具有统计学意义,提示试验组术后痛苦程度较对照组轻。Lund-Kennedy评分,术后6个月及术后1年试验组评分低于对照组（P<0.01）,差异具有统计学意义,提示术后病情控制试验组优于对照组。两组术后3个月的Lund-Mackay评分比较,差异无统计学意义（P=0.373）,提示试验组的手术后影像学改变与对照组相当。SNOT评分两组术前及术后1年相当,术后3个月试验组优于对照组。结论低温等离子射频消融技术用于CRSwNP的辅助鼻内镜手术治疗,有效、安全,可以达到传统手术效果,术中出血少,术后痛苦少,术后6个月及1年的远期疗效优于不结合使用等离子技术的传统功能性内镜鼻窦手术。

关键词: 低温等离子射频消融技术, 慢性鼻窦炎伴鼻息肉, 功能性内镜鼻窦手术

Abstract: Objective To investigate the feasibility of low-temperature plasma radiofrequency ablation in the surgical treatment of chronic rhinosinusitis with nasal polyps （CRSwNP）. Methods From January 2018 to June 2021, 48 patients with CRSwNP who met the inclusion criteria （experimental group） underwent cryogenic plasma radiofrequency ablation-assisted nasal endoscopic surgery, and another 44 patients underwent functional endoscopic sinus surgery （FESS） at the same time. Intraoperative blood loss volume, preoperative and postoperative visual analogue scale （VAS） score, Lund-Kennedy total score, Lund-Mackay score, and SNOT-20 score were compared between the two groups. Results The amount of intraoperative blood loss in the experimental group was less than that in the control group （P<0.01）. The VAS score of the experimental group was lower than that of the control group 3 months after surgery （P<0.05）, suggesting less postoperative pain in the experimental group. The Lund-Kennedy score of the experimental group was lower than that of the control group 6 months and 1 year after surgery （P<0.01）, suggesting better disease control in the experimental group. There was no significant difference between the two groups in the Lund Mackay score 3 months after surgery （P=0.373）, suggesting similar postoperative imaging changes. The SNOT score was not different between the two groups before surgery and 1 year after surgery, but was higher in the experimental group than in the control group 3 months after surgery. Conclusion Low-temperature plasma radiofrequency ablation is effective and safe in the nasal endoscopic treatment of CRSwNP, which can achieve the effect of traditional surgery, with less intraoperative bleeding, less postoperative pain, and better long-term efficacy 6 months and 1 year after surgery than FESS.

Key words: Low-temperature plasma radiofrequency Ablation, Chronic rhinosinusitis with nasal polyps, Functional endoscopic sinus surgery

中图分类号:

R765.4

钱越, 戴复, 柳娴, 王粟, 金玲. 低温等离子技术辅助鼻内镜手术治疗慢性鼻窦炎伴鼻息肉的临床研究[J]. 外科研究与新技术, 2021, 10(4): 253-259.

QIAN Yue, DAI Fu, LIU Xian, WANG Su, JIN Ling. Clinical study of nasal endoscopic surgery using low-temperature plasma radiofrequency ablation for chronic rhinoinusitis with nasal polyps[J]. Surgical Research and New Technique, 2021, 10(4): 253-259.

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低温等离子技术辅助鼻内镜手术治疗慢性鼻窦炎伴鼻息肉的临床研究

Clinical study of nasal endoscopic surgery using low-temperature plasma radiofrequency ablation for chronic rhinoinusitis with nasal polyps

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