广州医科大学学报

目的：比较分析鼻内镜Messerklinger中鼻甲成形术、鼻内镜中鼻甲部分切除术治疗慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者的效果。方法：选取我院98例（2018年12月～2021年1月）CRSwNP患者，依照随机数字表法分为两组，各49例。A组接受鼻内镜中鼻甲部分切除术治疗，B组接受鼻内镜Messerklinger中鼻甲成形术，比较两组治疗效果。结果：疗效：B组总有效率较A组高（P<0.05）；鼻腔功能：术后3个月，两组鼻腔功能均得到改善，且B组鼻腔最小横截面积（NMCA）、鼻腔容积（NCV）较A组高，气道阻力、鼻腔最小横截面至前鼻孔距离（DCAN）较A组小（P<0.05）；炎性应激：术后1 d，两组均出现炎性应激反应，而B组人软骨糖蛋白-39(YKL-40)、白细胞介素-5(IL-5)、转化生长因子-β1(TGF-β1)均低于A组（P<0.05）。结论：与鼻内镜中鼻甲部分切除术对比，鼻内镜Messerklinger中鼻甲成形术治疗CRSwNP，效果显著，能有效改善鼻腔功能，减小炎性应激。

Objective:To investigate the therapeutic efficacy of nasal endoscopic Messerklinger's middle turbinoplasty vs nasal endoscopic partial turbinate resection in treatment of chronic rhinosinusitis with nasal polyps(CRSwNP).Methods:A total of 98 CRSwNP patients who stayed in our hospital between December 2018and January 2021 were enrolled and divided into two groups according to the random number table(n= 49 each).The group A received partial resection of middle turbinate under nasal endoscopy,while the group B received nasal endoscopic Messerklinger's middle turbinoplasty. The therapeutic efficacy was compared between the two groups.Results:Regarding efficacy,total effective rate was higher in group B than that in group A(P<0.05).Regarding nasal function,either group experienced improvement in nasal function at 3 months after operation.Compared with group A,group B showed greater nasal minimum cross-sectional area(NMCA)and nasal cavity volume(NCV),lower airway resistance and shorter distance from the smallest cross-section of the nasal cavity to the anterior nostril(DCAN)(P<0.05). Regarding the inflammatory stress,either group showed inflammatory stress on day 1 after operation;however,the group B had lower human cartilage glycoprotein-39(YKL-40),interleukin-5(IL-5),and transforming growth factor-β1(TGF-β1)levels compared with group A(P<0.05).Conclusion:Compared with nasal endoscopic partial turbinate resection,nasal endoscopic Messerklinger's turbinoplasty for treatment of CRSwNP offers significant efficacy with effective improvement in nasal function and less inflammatory stress.