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目的:探讨治疗慢性肥厚性鼻炎4种不同术式的手术特点及下鼻甲黏膜超微结构的变化。方法:88例慢性肥厚性鼻炎患者行鼻内镜下鼻甲黏膜下成形术(A组),30例行下鼻甲部分切除术(B组),36例行射频消融下鼻甲减容术(C组),10例行下鼻甲硬化剂注射术(D组)。分别比较A、B、C3组术式治疗慢性肥厚性鼻炎的有效率、手术特点及术前、术后下鼻甲黏膜超微结构特征。结果:术后随访4～6个月,A、B、C3组的有效率分别为97.4%、100.0%和93.4%,差异无统计学意义(均P>0.05)。A组和C组术式优点突出,下鼻甲黏膜纤毛结构保存较好。结论:鼻内镜下鼻甲黏膜下成形术和射频消融下鼻甲减容术是治疗慢性肥厚性鼻炎较好的手术方法。
Objective: To investigate the surgical characteristics of four different surgical procedures for the treatment of chronic hypertrophic rhinitis and the changes of the ultrastructure of inferior turbinate mucosa. Methods: Eighty-eight patients with chronic hypertrophic rhinitis underwent nasal endoscopic turbinate submucosal angioplasty (group A), 30 underwent partial nasotomy (group B) and 36 patients underwent radiofrequency ablation of inferior turbinate (group C) ), 10 cases of inferior turbinate sclerotherapy (group D). The efficiency, operative characteristics and ultrastructural features of the inferior turbinate mucosa of A, B and C3 groups were compared respectively. Results: After 4 to 6 months of follow-up, the effective rates in groups A, B and C3 were 97.4%, 100.0% and 93.4%, respectively, with no significant difference (all P> 0.05). A group and C group surgical advantages of prominent, lower turbinate mucosal cilia structure is better preserved. Conclusion: Endoscopic sub-turbinate submucosal angioplasty and radiofrequency ablation of the inferior turbinate volume reduction is a better surgical treatment of chronic hypertrophic rhinitis.