以紅外線凝固法治療慢性鼻炎

Treatment of Chronic Rhinitis with Infrared Coagulation

郭玉奇(Yu-Chi Kou) ； 呂松柏(Sung-Pai Lui) ； 侯坤佑(Kun-Yu Hou) ； 林厚鈞(How-Jiun Lin)

《中華民國耳鼻喉科醫學雜誌》 35卷6期 (2000/12) Pp. 383-388

https://doi.org/10.6286/2000.35.6.383

摘要

背景:慢性鼻竇炎為耳鼻喉科門診中十分常見之疾病，且病例數有逐漸上升的趨勢。治療方法雖然很多，但臨床上仍有許多患者抱怨療效不彰。本科以紅外線凝固器(infraed coagulator)來治療慢性病鼻炎，並研究其療效。
方法；本科自1999年1月至1999年5月共收集了330名慢性鼻炎的病人，以紅外線凝固器施行雙側下鼻甲燒灼。每點時間設定為1.25秒，每側下鼻甲燒灼點數為8至10點。術後定期追蹤1年，並以Meltzer氏之鼻炎症狀評分表作為評分標準。每1名病人並接受血清多樣同時特異性抗體過敏試驗(serum multiple antigen simultaneous test, MAST)，且以spss統計套裝軟體進行分析，研究鼻部症狀改善情形，是否與下列因子有關；年齡、性別、MAST發現的有無、過敏原、IgE的濃度。
結果: 1)術後1年，病人主觀上獲得改善的情形如下；鼻塞60.2%，流鼻水22.3%，打噴嚏21.2%，鼻搔癢20.2%，而以鼻塞的改善最具有統計意義。2)症狀之改善並不因為性別不同、年齡差異、MAST檢驗的有無、過敏原的不同、血清總IgE 濃度之高低而有差別。3)在 MAST的分析內容中，過敏原已對顢類的Dermatiophagoides pteronyssinus(D.p)最多，佔全部人數的49.1%，其次為Dermatophagoides farinac (D.f) (47.9%)、家塵(15.8%)５蟑螂(11.3%)。
結論；以紅外線凝固器治療鼻塞確實有效，帶對流鼻水、打噴嚏、鼻搔癢的治療只有1/5 的成效。

關鍵字

慢性鼻炎 ； 紅外線凝固器

並列摘要

BACKGROUND: Chronic rhinitis is commonly encountered in ENT outpatient depart-maents and the number of cases is increasing gradually. Although treatments abound, many patients still complain about the ineffectiveness of the various therapies. We used an infrared coagulator to treat chronic rhinitis and assessed its therapeutic efficacy.
METHODS: Between January 1999 and May 1999, 330 patients with chronic rhinitis underwent bilateral inferior turbinate cauterizaton with an infrared coagulator. Each infe-rior turbinate required cauterization over eight to ten points. The duration of cauteriza-tion was set at 1.25 seconds for each point of application. Subjects were followed up for one year following the procedure. Meltzen’s Scale was used for rating pre-operative and post-operative symptoms. The results The results were analyzed with SPPS statistical software to investigate what, if any, relationship existed between improvements in nasal symptoms and factors including age, sex the presence of MAST, allergns, and IgE concentration.
RESULTS: One year after the procedure, the subjective improvement rates of reported symptoms were: obstruction (60.2%), runny nose (22.3%), and nasal itching(20.2%). Among them, the nasal obstruction improvement rate-was the most statistically significant. The improvement in symptoms was not affected by sex, age, the presence of MAST, differences in allergens, and concetrations of serum IgE. In the anal-ysis of MAST, Dermatophagoides pteronyssinus(D.p.) was the most important allergen, affecting up to 49.1%, followed by Dermatophagoides farinae(D.f.)(747.9%), house dust(15.8%), and cockroaches(11.3%).
CONCLUSIONS: The treatment of chronic rhinitis with infrared coagulation was effec-tive in treating nasal obstruction, but was only effective in twenty percent of patients reporting runny noses, sneezing, or nasal itching.

並列關鍵字

Chronic rhinitis ； infrared coagulator ； immunoglobulin E ； LgE