| BackgroundChronic rhinosinusitis(Chronic rhinosinusitis,CRS)refers to chronic inflammation of the sinuses and nasal mucosa with clinical symptoms such as nasal congestion,viscous or purulent nasal discharge,head and face pain,loss of olfactory or loss,and the course of disease is more than 3 months.The prevalence of CRS in China is about 8%.The disease lasts for a long time and is prone to repeated attacks,which has a serious impact on patients'lives.Functional endoscopic sinus surgery(FESS)is a common prescription for the treatment of CRS at present.However,the nasal cavity recovery of patients after FESS was not satisfactory,and the therapeutic effect was poor.Clinically,the combination of low temperature plasma ablation(TCRF)and FESS with minimally invasive features can significantly improve the nasal recovery of CRS patients with less damage to the morphology and function of nasal mucosa.ObjectiveTo investigate the clinical efficacy of FESS combined with TCRF in the treatment of CRS.MethodFrom July 2016 to February 2018,96 patients with CRS diagnosed by nasal sinus CT and nasal endoscopy were divided into two groups:group A and group B.Patients in group A were treated with FESS and TCRF,and patients in group B were treated with FESS.The operative time,bleeding volume and hospitalization time in group A and B were observed and analyzed.Patients in groups A and B were followed up at 3 and 6 months after surgery to record clinical efficacy and postoperative complications.The visual analogue score(VAS)before and after surgery,the Lund-Kennedy scale after surgery,and the nasal mucosal structure and mucociliary transport rate(MTR)before and after surgery.Data processing was performed using statistical software SPSS 18.0.Result1.Compared with the B group,the operation time,the amount of bleeding during surgery were lower in the A group than in the B group.There was a statistically significant difference.(P<0.05).2.There was no significant difference in VAS scores between the A and B groups before surgery(P>0.05).At 3 months after surgery,the VAS scores of patients in group A and group B were lower than those before surgery(P<0.05).The VAS score and Lund-Kennedy score in group A were lower than those in group B Significant difference(P<0.05).3.Different degrees of inflammatory cell infiltration,hemorrhage,edema and necrosis appeared in the maxillary sinus epithelium before operation Three months after the operation,there were more a large number of goblet cells secreting mucus between the maxillary sinus nasal mucosa in group A and B,and fewer inflammatory cells.However,the postoperative recovery of mucosal epithelium with different degrees of inflammation in group A was significantly better than that in group B.4.There was no significant difference in MTR between group A and group B before operation(P>0.05).The MTR of group A was higher than that before operation at 6months after operation(P<0.05).Group B patients had MTR.There was no significant difference from preoperative(P>0.05).The MTR of group A patients was higher than that of group B at 6 months after surgery,and there was a significant difference(P<0.05).5.The complication rate of patients in group A and group B was compared at 6months after operation.The complication rate of group A was 4.17%and that of group B was 16.65%.There was significant statistical difference(?~2=4.018,P<0.05).6.The total effective rate of group A and group B was 97.92%and 83.33%,respectively.The total effective rate of group A was higher,and there was significant statistical difference(?~2=6.008,P=0.015).At 6 months after surgery,the total effective rate of group A and group B was 95.83%and 81.25%,respectively.The total effective rate of group A was higher,and there was significant statistical difference(?~2=5.051,P=0.025).ConclusionFESS combined with TCRF for CRS treatment can not only reduce trauma,but also significantly improve the clinical efficacy of CRS. |
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