Endoscope on nasal cavity structure adjustment technology ofmicroscope
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摘要:
目的探讨伴有临床症状的鼻腔结构异常患者的治疗技术，总结内窥镜下鼻腔结构调整技术的临床治疗经验。 方法对86例排除了鼻腔鼻窦新生物而确诊为鼻腔结构异常的伴有临床症状的患者实施“个性化内窥镜下鼻腔结构调整技术，即：个性化的“鼻内镜下鼻中隔三线减张矫治术、鼻腔结构调整（鼻中甲内移固定和减容、鼻下甲骨折移位和减容）、中鼻道鼻窦开放术，同时联合等离子低温消融技术”并进行临床总结；同时对所有患者术前和术后3月时的鼻阻力测量评分、鼻堵塞VAS评分、鼻内镜检查评分和鼻窦CT检查评分进行临床对比分析。 结果86例患者的手术进程顺利，双侧鼻腔异常结构的矫正满意、通气容积扩大、通气的对称性恢复；全部病例中中隔粘骨膜切口愈合良好，术后均未出现鼻中隔脓血肿、中隔对穿孔、鼻梁塌陷、空鼻不适等手术并发症；患者总鼻阻力值由术前的0.643±0.142 KPa/L.S变为术后3个月时的0.278±0.154 KPa/L.S（P < 0.05）；主观鼻腔通气程度（VAS）评分由术前的6.696±1.532变为术后3个月时的3.378±1.371（P < 0.05）；鼻内镜检查Lund-Kennedy评分由术前的0.81±0.69变为术后3个月时的0.52±0.69（P < 0.05）；鼻窦CT检查Lund-Mackay评分由术前的11.02±1.34变为术后3个月时的4.37±1.05（P < 0.05），均具有统计学意义。 结论对伴有临床症状的“鼻腔鼻窦解剖结构异常的”患者实施“个性化内窥镜下鼻腔结构调整技术”，对扩展鼻腔鼻窦有效通气容积、有效降低鼻腔通气阻力、减轻或缓解上气道阻塞是安全实用、经济有效的。 Abstract:Objective To study on abnormal in patients with nasal cavity structure with clinicalsymptom treatment technolgy, to summarize the clinical experience in the treatment of nasal endoscopic technique of structural adjustmentunder the microscope. Methods In 86 cases of nasal cavity and paranasal sinuses and exclusion of newbiological diagnosed with structural abnormality of nasal cavity with clinical symptoms in patients with the implementation of personalizedendoscopic nasal struture adjustment technology, namely: personalized endoscopic nasal septum three line tension reduction correction surgery, nasal cavity structure adjustment (middle turbinate shift in fixed andvolume reduction, nose a fracture displacement and volume reduction), the middle nasal meatus open sinus surgery, combined with low-temperature plasma ablation technique and clincal summary; at the same time, score, nasal resistance measured in all patients before andafter operation of nasal blocage in March when the VAS score, endoscopic examination score and sinus CT examination score of clinical comparative analysis. Results 86 cases of patients with operation process smoothly, symmetry, volumeexpansion, satisfactorycorrectionof ventilation ventilation recoverybilateral nasal structural abnormality; in all cases and septalmucoperiosteal incision healed well, no patient had nasal septumperforation, hematoma, abscess septum on bridge collapse, empty nasaldiscomfort in patients with nasal operation complication; resistance from preoperative values of 0.643±0.142 KPa/L.S to 0.278±0.154KPa/L.S at 3 months after operation (P < 0.05); subjective nasal patency (VAS) score from preoperative 6.696±1.532 is changed to 3.378±1.371 at 3 months after operation (P < 0.05); nasal endoscopy Lund-Kennedy score from preoperative 0.81±0.69 is changed to 0.52±0.69 at 3 months after operation (P < 0.05); sinus CT examination Lund-Mackay scores by preoperative 11.02±1.34 is changed to 4.37±1.05 at 3 months after operation (P < 0.05);, there is statistical significance. Conclusion On the "accompanied by clinical symptoms of nasal cavity and paranasal sinuses anatomic abnormalities in patients with the implementation of the "personalized "endoscopic nasal structure adjustment technology", Extension of the nasal cavity and paranasal sinus effective ventilationvolume, reduce nasal resistance, ease of upper airway obstruction is safe and practical, economic and effective. -
Key words:
- The nasal cavity structure adjustment /
- endoscope /
- clinical summary
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表 1 手术前及术后3 个月的鼻窦CT检查Lund-Mackay评分的比较
鼻窦 侧别 术前平均分值 术后3个月平均分值 术前与术后3个月评分比较的P 上颌窦 左 2.01 0.98 0.03★ 右 1.23 0.57 0.01★ 前组筛 左 1.03 0.48 0.06★ 窦 右 1.43 0.59 0.09★ 后组筛 左 0 0 0.00★ 窦 右 0 0 0.00★ 蝶窦 左 0 0 0.00★ 右 0 0 0.00★ 窦口复 左 2.06 0.83 0.01★ 合体 右 3.26 0.92 0.02★ 每侧 左 5.1 2.29 0.00★ 评分 右 5.92 2.08 0 ★：术后3 个月与术前比较，鼻相关症状有统计学意义（P<0.05） 
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