贵州医科大学学报

2010, (05) 451-455

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下鼻甲外侧壁部分切除联合骨折外移术治疗慢性肥厚性鼻炎
A Study on Partial Resection Plus Relocation Fracture Surgery of Inferior Turbinate in Treatment of Chronic Hypertrophic Rhinitis

陈传成;陈乾美;程永华;
CHEN Chuancheng1,CHEN Qianmei1,CHENG Yonghua2 (1.Department of Otorhinolaryngology,the Affiliated Hospital of Guiyang Medical College,Guiyang 550004,Guizhou,China;2.Department of Otorhinolaryngology,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China)

摘要(Abstract):

目的:分析治疗慢性肥厚性鼻炎(chronic hypertrophic rhinitis,CHR)3种下鼻甲手术的特点,为治疗CHR提供最佳参考术式。方法:148例CHR患者随机分为3组:第一组52例行下鼻甲外侧壁部分切除联合骨折外移术,第二组46例行下鼻甲黏-骨膜下部分切除术,第三组50例行下鼻甲黏膜部分切除术,记录术中出血量,术后鼻腔粘连、继发鼻出血、鼻腔干燥的发生例数,记录黏液纤毛传输速率(mucociliary transport rate,MTR)。结果:术后随访6个月,第一、二、三组总有效率分别为98.08%、95.65%、92.00%,差异无显著性(P>0.05);第一组术中出血量明显少于其他两组,差异有显著性(均P<0.05);比较患者的MTR及术后并发症的发生情况,第一组与第二组无明显差异(均P>0.05),而第一组与第三组比较差异有显著性(P<0.05)。结论:下鼻甲外侧壁部分切除联合骨折外移术治疗CHR具有疗效好、术中出血少、术后并发症少、鼻黏膜纤毛功能保护好等优点,是治疗慢性肥厚性鼻炎的有效手术方法。
Objective: To provide an operative method for treatment of chronic hypertrophic rhinitis(CHR) by comparing results of three operative methods on inferior turbinate.Methods: One hundred and forty-eight cases of CHR were randomly divided into three groups.Group F including 52 cases were treated with partial resection of lateral wall and out-fracture surgery on inferior turbinate,group S with 46 cases were treated with submucoperiosteous resection on inferior turbinate bone,and group T with 50 cases were treated with partial inferior turbinectomy.For all the 3 groups,operating bleeding-volumes and postoperative complications such as nasal adhesion,secondary epistaxis,and nasal dryness were recorded,curative effects were assessed according to evaluation standard respectively.Mucociliary transport rate(MTR)of each group was detected with Saccharin Test.The data of group F were compared with those of group S and group T respectively.Results: All the patients were followed up for six months after operation.Total effective rates of group F,group S,and group T were 98.08 %,95.65 %,and 92.00% respectively,but the differences among them were not significant statistically(P>0.05).The bleeding volume of group F during operation was significantly less than those of the other two groups,and the differences were significant(P<0.05).In regard of MTR and postoperative complications,there was no significant difference between groups F and S(P>0.05),while the differences between groups F and T were markedly(P<0.05).Conclusions: Partial relocation of lateral wall combined with relocation fracture surgery on inferior turbinate for treatment of CHR is worthy to be recommended as a surgical method with good efficacy,less bleeding,fewer complications,and good protection to nasal mucosacilia function.

关键词(KeyWords): 鼻甲;鼻炎;外科手术;骨折
turbinates;rhinitis;surgical procedures,operative;fractures

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基金项目(Foundation): 贵州省优秀人才省长基金(S2004-5)资助

作者(Author): 陈传成;陈乾美;程永华;
CHEN Chuancheng1,CHEN Qianmei1,CHENG Yonghua2 (1.Department of Otorhinolaryngology,the Affiliated Hospital of Guiyang Medical College,Guiyang 550004,Guizhou,China;2.Department of Otorhinolaryngology,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China)

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