Objectives: Nasal congestion is often the main symptom of the patients with non-allergic rhinitis, who have inferior turbinate hypertrophy if getting poor treatment effect. Plasma treatment for inferior turbinate hypertrophy can effectively improve nasal obstruction. Generally, plasma treatment with multiple puncture sites, makes patients intraoperative painful and postoperative bleeding, which let patients often fear of surgery. Postoperative nasal adhesion or lower turbinate scar and other complications sometimes happened, and some patients still feel nasal obstruction due to severe mucosal damage and scar formation. We innovatively used one-point-three-side plasma turbinate volume reduction in the treatment of inferior turbinate hypertrophy, in order to reduce complication, improve symptoms, and enhance curative effect.
Methods: A total of 111 patients with non-allergic rhinitis with complete data due to hypertrophy of inferior turbinate and poor drug treatment from Nov. 2011 to Oct. 2019. The hypertrophic inferior turbinate of patients with non-allergic rhinitis was ablated by plasma turbinate volume reduction, and the symptom scores of patients were evaluated by visual analog scales (VAS) before surgery, 1 week, 1 month, 3 months, and 6 months after surgery. The intraoperative pain was scored by VAS. The pathological morphology of nasal mucosa was observed before and after operation in some patients.
Results: The nasal obstruction score of the patients was significantly lower at 1 week, 1 month, 3 months and 6 months after the operation (all P<0.05). The distribution of submucosal blood vessels and glands was improved by postoperative pathological observation.
Conclusions: Plasma turbinate volume reduction with one-point-three-side is effective with minimally invasion, and less complication, which is worthy of clinical promotion.
目的: 药物治疗效果不佳的非变应性鼻炎患者以鼻塞为主要症状，内镜检查可发现下鼻甲肥厚。等离子治疗下鼻甲肥厚可改善鼻塞症状，但常规等离子治疗往往需要在多个穿刺点下进行，患者术中疼痛，术后出血发生率较高，且存在术后鼻腔粘连或下鼻甲瘢痕等并发症。患者术后尽管鼻腔通畅，但可能因为黏膜损伤严重，瘢痕形成而仍然感觉鼻塞。本研究使用一点三面法等离子鼻甲减容术治疗下鼻甲肥厚，旨在减少并发症，改善症状，提高疗效。方法: 纳入2011年11月至2019年10月因下鼻甲肥厚且药物治疗效果不佳的资料完整的111例非变应性鼻炎患者。患者均行一点三面法等离子鼻甲减容术，采用视觉模拟评分法(Visual Analogy Scale，VAS)对术中疼痛进行评分，并用VAS评估患者术前、术后1周、1个月、3个月和6个月的鼻塞症状。对部分患者术前和术后鼻黏膜行病理形态观察。结果: 患者术中疼痛轻，出血少，术后1周、1个月、3个月和6个月鼻塞评分均较术前显著降低(均P<0.05)。术后病理观察也提示改善了黏膜下血管和腺体的分布。结论: 一点三面法等离子鼻甲减容术治疗下鼻甲肥厚微创、有效，并发症少，值得临床推广.
Keywords: coblation; inferior turbinate hypertrophy; non-allergic rhinitis; pathology; treatment.