Braz J Otorhinolaryngol:后鼻神经切除术在过敏性鼻炎患者中的长期结果

2021-06-22 AlexYang MedSci原创

过敏性鼻炎(AR)是一种免疫球蛋白E(IgE)介导的鼻粘膜炎症,对特定的过敏原产生反应,导致的症状包括瘙痒、鼻塞、水样鼻涕,以及在没有感染时打喷嚏。AR患者还可能有眼部症状、慢性咳嗽和鼻后滴漏,大大降

过敏性鼻炎(AR)是一种免疫球蛋白E(IgE)介导的鼻粘膜炎症,对特定的过敏原产生反应,导致的症状包括瘙痒、鼻塞、水样鼻涕,以及在没有感染时打喷嚏。AR患者还可能有眼部症状、慢性咳嗽和鼻后滴漏,大大降低了一部分患者的生活质量。AR的一线治疗通常包括使用第二代非镇静性抗组胺药和鼻内类固醇。对于那些对药物治疗没有表现出满意反应的患者,皮下或舌下过敏原特异性免疫疗法通常可以有效地缓解症状。

近期,有研究人员比较了后鼻神经切除术(有或没有咽丛神经切除术)对治疗中度至重度常年性过敏性鼻炎的临床疗效。次要的研究目的包括比较这两种手术治疗组的患者的并发症的严重程度,包括慢性咳嗽和哮喘。

共有52名患者参加了这项随机对照试验,并分配到对照组(后鼻神经切除术)或实验组(后鼻神经切除术+咽部神经切除术)。视觉模拟量表和鼻结膜炎生活质量调查表用来比较基线和治疗后6、12和24个月之间患者症状的差异。此外,在随访期间,研究人员分别通过视觉模拟量表和哮喘控制测试监测患者的咳嗽和哮喘症状。

结果发现,各组之间的术前评分没有明显的差异(P>0.05)。治疗后6个月,实验组和对照组患者的视觉模拟量表、鼻结膜炎生活质量调查表和哮喘控制测试得分相对于基线值有明显差异(P<0.05),并在第12个月和第24个月的随访中得以保持。在术后任何一个随访时间点,两组治疗患者的视觉模拟量表、鼻结膜炎生活质量调查表或哮喘控制测试得分均无明显差异(P>0.05),但实验组的咳嗽严重程度相对于对照组明显降低(P<0.05)。

试验组和对照组的VAS得分均值情况

综上所述,后鼻神经切除术可以有效地治疗过敏性鼻炎,也可以不进行咽部神经切除术。在治疗过敏性鼻炎患者的慢性咳嗽方面,后鼻神经切除术和咽神经切除术联合治疗可能比单纯的后鼻神经切除术效果更好

原始出处:

Hongting Hua, Guoyuan Wang, Yi Zhao et al. The long-term outcomes of posterior nasal neurectomy with or without pharyngeal neurectomy in patients with allergic rhinitis: a randomized controlled trial. Braz J Otorhinolaryngol. May 2021

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