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研究生:蔡曜隆
研究生(外文):YaoLung
論文名稱:以下鼻甲半導體雷射手術治療過敏性鼻炎的長期效果調查
論文名稱(外文):Diode Laser Treatment of Allergic Rhinitis—A Long Term Outcome Survey
指導教授:李鴻森李鴻森引用關係
指導教授(外文):HongShen Lee
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:51
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背景:過敏性鼻炎是常見的慢性病之一。本研究之目的在調查有確定過敏原之過敏性鼻炎患者,接受下鼻甲半導體雷射(Diode laser)手術治療其過敏性鼻炎之長期效果。
方法:追蹤在88年9月至89年5月間接受下鼻甲半導體雷射手術治療其過敏性鼻炎,且有確定過敏原之過敏性鼻炎患者,以Allergy outcome survey(AOS)問卷,調查其下鼻甲半導體雷射手術後三個月、六個月、一年及六年後之症狀改善度及藥物使用量。共調查42位患者。
結果:所有患者皆無術後出血而須鼻部填塞止血的情形,六年之後仍有回覆者有25位(回覆率60%)。Allergy outcome survey(AOS)問卷調查中的症狀分數(Symptom Score)在三個月、六個月、一年及六年後有改善的患者比率為74%、67%、48%、64%;而藥物使用分數(Medication Score)在三個月、六個月、一年及六年後有改善的患者比率為59%、56%、41%、64%;總和分數(Total Score)(即症狀分數加上藥物使用分數)在三個月、六個月、一年及六年後有改善的患者比率為70%、70%、56%、72%。
結論:以下鼻甲半導體雷射手術治療過敏性鼻炎的效果,依據統計分析,在六年後仍會有症狀上的改善;且在藥物使用量及總和分數(即症狀分數加上藥物使用分數)上,在下鼻甲半導體雷射手術六年後與手術前相比較,皆仍具有統計上顯著意義之改善。


Background:Allergic rhinitis is one of the most common chronic condition. The purpose of this study is to measure the outcome of treatment of allergic rhinitis with diode laser in contact mode, with a long-term follow-up of 6 years.
Methods:From September 1999 to May 2000, forty-two newly diagnosed patients participated in the study .These 42 consecutive patients were treated with a continuous diode laser (wavelength:805nm, laser parameter:12W) in “contact” mode and under local anesthesia. All patients were refractory to conservative medical treatment. After a follow-up of 6 years, we measured the result of treatment by an allergy outcome survey questionnaire in the 3 months, 6 months, 1 year and 6 years following the operation.
Results:Twenty-five of 42 patients (60%) who replied filled out the questionnaire completely. The mean operation time took 1 minute and 28 seconds per patient, no nasal packing was necessary and no complication (e.g., major bleeding) was observed.
Statistical analysis revealed:except the medication score in post-operation 1 year, significant improvement in the symptom score, medication score and total score 3 months,6 months,1 year and 6 years after laser surgery were found. A total of 64% of the patients described the improvement of medication score and 72% of the patients described the improvement of total score 6 years after laser treatment. The outcome of laser surgery still persists for 6 years after dioide laser surgery.
Conclusion:Long-term follow-up of 6 years results revealed that diode laser treatment of allergic rhinitis is an useful procedure, which can be performed as an outpatient surgery under local anesthesia. The short operation time and less discomfort provide other reasons for choosing this treatment for allergic rhinitis.


第一章 緒論
第一節 研究背景-----------------------------------1
第二節 研究動機與目的--------------------------8
第三節 研究假說-----------------------------------9
第二章 文獻探討
第一節 雷射在醫療上的應用--------------------10
第二節 鼻部雷射手術之發展--------------------12
第三節 半導體雷射之特性-----------------------13
第四節 治療效果的評估工具--------------------14

第三章 研究設計與方法
第一節 研究流程-----------------------------------17
第二節 研究工具-----------------------------------18
第三節 研究對象-----------------------------------21
第四節 分析方法-----------------------------------22
第四章 研究結果
第一節 研究對象基本資料-----------------------23
第二節 描述性統計分析--------------------------25
第三節 研究變項之差異分析--------------------28
第五章 討論
第一節 下鼻甲半導體雷射手術--------------------29
第二節 評估治療效果工具--------------------------30
第三節 干擾因子--------------------------------------32
第四節 研究限制--------------------------------------34
第六章 結論與建議---------------------------------------35
參考文獻-----------------------------------------------36


表目錄
表1血清特異性抗體過敏原檢查之Class與實際
單位之對照表--------------------------------------20
表2問卷調查之原始分數-----------------------------------26
表3雷射治療後問卷分數有改善的人數及比例--------27
表4以統計方法比較術前與術後問卷分數的差異-----28

圖目錄
圖1 研究流程圖----------------------------------------17
圖2下鼻甲半導體雷射手術的實施圖--------------------18
圖3 Allergy outcome survey(AOS)問卷------------49
圖4 研究對象追蹤情形--------------------------------------24


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