赵霞 王黎明

[摘要] 目的 观察低温等离子消融术应用于功能性内镜鼻窦手术的临床疗效及安全性。方法 2013年5月—2016年4月，方便选取110例鼻腔鼻窦手术患者按照治疗方法不同分为治疗组与对照组各55例，分别给予低温等离子消融术+功能性内镜鼻窦手术、传统鼻息肉手术治疗，比较两组患者的治疗效果、术后并发症及复发情况。结果 治疗组总有效率明显高于对照组（100.0%和89.1%，χ2=9.352，P<0.01），；两组患者手术前SNOT-20及Lund-Kennedy评分比较差异无统计学意义（P>0.05），术后6个月治疗组较术前、同期对照组均差异有统计学意义（P<0.05）；治疗组术后并发症发生率及随访复发率比较均明显少于对照组，差异有统计学意义（P<0.05）。结论 低温等离子消融术应用于功能性内镜鼻窦手术可显著提高手术疗效、减少术后并发症及短期复发率，值得推广应用。

[关键词] 低温等离子消融术；功能性内镜；鼻窦手术；疗效

[中图分类号] R765 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0070-03

Clinical Analysis of Low Temperature Plasma Ablation for Functional Endoscopic Sinus Surgery

ZHAO Xia， WANG Li-ming

Department of ENT， Beijing Miyun District Hospital， Beijing， 101500 China

[Abstract] Objective This paper tries to observe the clinical efficacy and safety of low temperature plasma ablation for functional endoscopic sinus surgery （ESS）. Methods From May 2013 to April 2016， 110 patients undergoing nasal sinus surgery were convenient selected and divided into treatment group and control group according to the different treatment methods， 55 patients were treated with low temperature plasma ablation + functional endoscopic sinus surgery， traditional nasal polyps surgery treatment， the treatment effect of two groups of patients， postoperative complications and recurrence were compared. Results The total effective rate in the treatment group was significantly higher than the control group（100.0% and 89.1%， χ2=9.352， P<0.01）； there were no significant difference compared between the two groups of postoperative SNOT-20 and Lund-Kennedy scores（P>0.05）， and the postoperative 6 months SNOT-20 and Lund-Kennedy scores in the treatment group compared with the preoperative and the control group were significantly different（P<0.05）； The preoperative incidence of complications and recurrence rate in the treatment groupwere significantly less than the control group， with significant difference（P<0.05）. Conclusion The application of low temperature plasma ablation in functional endoscopic sinus surgery can significantly improve the curative effect， reduce postoperative complications and short-term recurrence rate， and is worthy of popularization and application.

[Key words] Low temperature plasma ablation； Functional endoscopy； Sinus surgery； Curative effect1985年美國Kennedy最早提出功能性内镜鼻窦手术（functional endoscopic sinus surgery，FESS）的概念，根据内镜下所见及鼻部CT扫描所示在内镜下准确彻底地清除中鼻道窦口鼻道复合体病变、开放筛窦、扩大上颌窦自然开口、额窦口和蝶窦口，从而既彻底清除鼻窦病变，又保留鼻腔鼻窦的正常功能。之后FESS逐渐成为了治疗鼻腔鼻窦疾病的主要方法，其较传统的鼻窦手术具有更高的准确性和微创性，且有利于降低术后复发率[1]。该院2013年5月—2016年4月收治的55例鼻腔鼻窦手术患者在施行FESS时应用低温等离子消融术，效果更佳，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的110例鼻腔鼻窦手术患者按照治疗方法不同分为治疗组与对照组各55例，选取病例均经鼻内镜检查确诊且符合手术适应征，且经保守治疗4周以上无效或效果不明显。治疗组55例患者包括慢性筛上颌窦炎11例，慢性额窦炎7例，慢性蝶窦炎9例，鼻息肉伴慢性鼻窦炎28例；……