不可逆电穿孔用于成人下鼻甲减容消融

文献信息

中文摘要

背景： 下鼻甲肥大是鼻气道阻塞的常见原因。理想的手术方式应在有效减容的同时保留黏膜完整性并尽量减少术后并发症。
目的： 评估不可逆电穿孔（IRE）用于下鼻甲肥大非热消融的安全性和有效性。
方法： 这项前瞻性、多中心、单臂研究纳入因下鼻甲肥大导致症状性鼻塞且药物治疗难治的成年患者。所有患者均使用ENTire系统接受IRE下鼻甲减容术。在基线和1周、1个月、3个月时，使用鼻阻塞症状评估（NOSE）、鼻阻塞视觉模拟量表（NO-VAS）和22项鼻-鼻窦结局测试（SNOT-22）评估结局。同时评估术后疼痛和临床愈合情况。
结果： 48例患者完成了研究。所有结局指标均观察到显著改善。3个月时，NOSE评分均值从74.38 ± 13.39降至11.25 ± 9.20，NO-VAS评分从69.55 ± 19.48降至12.51 ± 11.81，SNOT-22评分从33.06 ± 24.18降至7.48 ± 10.37（均p < 0.0001）。改善在1周时即已明显，并随随访进展。术后疼痛较轻。未发生重大并发症，短暂黏膜改变在3个月时消退。
结论： IRE是一种有前景的非热、微创下鼻甲减容技术，可显著改善症状且术后并发症少。需要更大样本、更长随访的研究来确认其持久性。

英文摘要

BACKGROUND: Inferior turbinate hypertrophy is a common cause of nasal airway obstruction. An optimal surgical approach should provide effective volume reduction while preserving mucosal integrity and minimizing postoperative morbidity.
OBJECTIVE: To evaluate the safety and efficacy of irreversible electroporation (IRE) for non-thermal ablation of inferior turbinate hypertrophy.
METHODS: This prospective, multi-center, single-arm study included adult patients with symptomatic nasal obstruction due to inferior turbinate hypertrophy refractory to medical therapy. All patients underwent IRE turbinate reduction using the ENTire system. Outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE), Nasal Obstruction Visual Analog Scale (NO-VAS), and the 22-item Sino-Nasal Outcome Test (SNOT-22) at baseline and at 1 week, 1 month, and 3 months. Postoperative pain and clinical healing were also evaluated.
RESULTS: Forty-eight patients completed the study. Significant improvement was observed across all outcome measures. The mean NOSE score decreased from 74.38 ± 13.39 to 11.25 ± 9.20, the NO-VAS score from 69.55 ± 19.48 to 12.51 ± 11.81, and the SNOT-22 score from 33.06 ± 24.18 to 7.48 ± 10.37 at 3 months (all p < 0.0001). Improvement was evident at 1 week and progressed through follow-up. Postoperative pain was low. No major complications occurred, and transient mucosal changes resolved by 3 months.
CONCLUSION: IRE is a promising non-thermal, minimally invasive technique for inferior turbinate reduction, providing significant symptom improvement with low postoperative morbidity. Larger studies with longer follow-up are needed to confirm durability.