Ear Nose Throat J:后鼻神经冷冻消融术对慢性鼻炎患者的症状和特定疾病的生活质量的影响

2021-07-06 AlexYang MedSci原创

慢性鼻炎在美国影响了8000多万人,通过流行研究的推断,全世界受影响的人口大约有4.5亿。受这种疾病过程影响的人口规模使得可查的其对经济影响。在21世纪初,仅过敏性鼻炎(AR)就造成了超过30亿美元的

慢性鼻炎在美国影响了8000多万人,通过流行研究的推断,全世界受影响的人口大约有4.5亿。受这种疾病过程影响的人口规模使得可查的其对经济影响。在21世纪初,仅过敏性鼻炎(AR)就造成了超过30亿美元的直接医疗费用和超过110亿美元的治疗费用。

初步数据显示,后鼻神经(PNN)冷冻消融术对减轻过敏性鼻炎(AR)和非过敏性鼻炎(NAR)患者的鼻炎症状有长期疗效。近期,有研究人员评估了PNN的程序性冷冻消融对AR和NAR患者生活质量(QOL)的影响

在接受适当的药物治疗后,研究人员将接受PNN冷冻消融术治疗AR或NAR的成年患者纳入了分析。记录了人口统计学、医疗疗法、基线鼻炎症状(鼻部症状总分[TNSS])和疾病特定的生活质量(迷你鼻结膜炎生活质量问卷[mini-RQLQ])。

有14名患者参加了治疗,平均随访时间为16.5周。PNN冷冻消融术后,TNSS和mini-RQLQ评分明显改善(中位数δs[四分位数范围]:分别为-4[3]和-1.61[1.08];两者的P=0.0002)。每个类别中92.9%的患者获得了TNSS和mini-RQLQ的最小临床重要差异。所有患者在PNN冷冻消融后,TNSS和mini-RQLQ的相对平均改善百分比(%)分别为40.7%和40.5%(标准差分别为24.9和29.5)。NAR患者(n=10)报告的TNSS测量的平均改善率为41.3%(29.1),mini-RQLQ为49.6%(25.9)。AR患者报告TNSS和mini-RQLQ得分的平均改善百分比分别为39.5%(12.1)和24.6%(28.5)。在PNN冷冻消融术前曾用过鼻腔抗胆碱能药物的患者,术前到术后mini-RQLQ评分的改善程度也有统计学显著意义(P=0.0387)。

PNN冷冻消融治疗后TNSS和mini-RQLQ的变化

综上所述,PNN的冷冻消融术可显著改善大多数AR和NAR患者的症状和疾病特异性QoL

原始出处:

Farrukh R Virani , Machelle D Wilson , Angela M Beliveau et al. The Impact of Surgical Posterior Nasal Nerve Cryoablation on Symptoms and Disease-Specific Quality of Life in Patients With Chronic Rhinitis. Ear Nose Throat J. Jun 2021

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