变应性鼻炎的外科手术治疗专家共识（2022，上海）

Expert consensus on surgical management of allergic rhinitis(2022, Shanghai)

摘要:

变应性鼻炎（AR）是一种变应原致敏和激发引起的、有神经介质参与的特异性IgE介导的、Th2类型鼻黏膜慢性炎症。AR的外科手术作为二线治疗手段，能够有效改善顽固性鼻塞和鼻黏膜高分泌及高敏感性反应，临床上推荐酌情使用。但目前AR的外科手术还存在一些争议性问题，诸如适应证的选择、并发症规避及疗效评价等。有鉴于此，中国鼻病研究协作组召集国内中青年鼻科专家，基于临床经验和循证医学证据制订了AR的外科手术治疗专家共识。本共识从AR手术治疗历史、相关解剖与生理病理学原理等角度出发，系统总结了AR手术治疗中的相关机制、手术方式与适应证选择，以及并发症处理与注意事项等，旨在指导并规范临床医师开展AR外科手术治疗，以期进一步拓展AR的治疗方式并提高相应的治疗疗效。

Abstract:

Allergic rhinitis (AR) is a specific IgE mediated Th2 type chronic inflammation of nasal mucosa caused by allergen sensitization and stimulation with the participation of neurotransmitters. As a second-line treatment, surgery for AR can effectively relief intractable nasal congestion and nasal mucosal hypersecretion and hypersensitivity, which is recommended to be used as appropriate in clinic. However, there are still some controversial issues in AR surgery, such as the selection of surgical indications, avoidance of complications, and evaluation of efficacy. In view of this, the Chinese Rhinopathy Research Cooperation Group convened domestic young and middle-aged rhinology experts to formulate an expert consensus on surgical treatment of AR based on clinical experience and evidence-based medical evidence. This consensus systematically summarizes the relevant mechanisms, surgical methods and indication selection, as well as complication treatment and precaution in AR surgical treatment from the perspective of AR surgical treatment history, relevant anatomical and physiological and pathological principles, in order to guide and standardize clinicians to carry out AR surgical treatment, so as to further expand the treatment methods of AR and improve the corresponding therapeutic efficacy.