摘要
目的探讨慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)患者行鼻腔结构重塑前后的主客观评估及相关性研究。方法对70例CRS患者鼻内镜下行下鼻甲射频消融外移术、中鼻甲成形术及窦口鼻道复合体功能性切除术,同期行鼻中隔黏膜下矫正术。术前对所有患者作主观症状视觉模拟量表(visual analog scale,VAS)调查、客观检查及评分、Lund-Kennedy内镜评分和Lund-Mackay CT评分。术后随访1年,分别行以上3种评分,并作相关性分析。结果术前VAS评分总分与CT评分呈显著正相关(r=0.39,P<0.01),内镜评分与CT评分呈正相关(r=2.11,P<0.05),但嗅觉障碍的VAS评分与内镜、CT评分无相关性,差异无统计学意义。术前VAS与术后VAS评分差异具有统计学意义(t=39.51,P<0.01),术后VAS与术后内镜评分差异具有统计学意义(r=0.59,P<0.01),术前与术后Lund-Kennedy内镜评分比较差异具有统计学意义(t=39.30,P<0.01)。结论术前VAS评分、CT评分、内镜评分呈正相关,术后随访1年,手术后主观症状VAS总分与术前差异具有统计学意义,与术后Lund-Kennedy内镜评分呈正相关。术前及术后的鼻塞、头晕、面部疼痛、鼻漏症状与客观评估有相关性。手术需多方面评价,有利于个体化的手术。
Objective To investigate the objective and subjective assessment of structural remodeling of nasal cavity in chronic rhinosinusitis （CRS） patients and their correlation. Methods Seventy patients with CRS were treated with endoscopic structural remodeling of nasal cavity, including endoscopic submueous septoplasty, radiofrequency volumetric tissue reduction and shift of inferior turbinate, middle turbinoplasty, and functional resection of ostiomeatal complex. The objective assessment of VAS scales and subjective assessments of Lund-Kennedy endoscopic scales and Lund-Mackay CT scales were applied to all the patients before operation and one year after operation. The correlation among different assessment was analyzed. Results The preoperative total scales of VAS were positively correlated with those of Lund-Mackay CT （ r = 0.39, P 〈 0.01 ） , and the preoperative scales of Lund-Mackay CT were positively correlated with Lund-Kennedy endoscopic scales （ r = 2. 11 , P 〈 0.05 ）. But there weren ＇t any correlation between the scale of hyposmia and Lund-Kennedy scale or Lund-Mackay scale. One year after operation, the scales of VAS, Lund-Kennedy, and Lund-Mackay were statistically different from the preoperative ones respectively （ P 〈 0.01 ）. Conclusion In CRS patients, the preoperative scales of VAS, CT assessment, and endoscopic evaluation are correlated with each other. One year after operation, the scale of YAS is statistically different from the preoperative one, and positively correlated with the postoperative Lurid-Kennedy endoscopic scale, which indicates that an allround evaluation of the patients with CRS is necessary to facilitate the individualization of surgical treatment.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2012年第4期270-274,共5页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
梅州市科技局资助项目(2011B60)
关键词
鼻-鼻窦炎
鼻内镜术
结构性
重塑
评估
Sinusitis, chronic
Endoscopic sinus surgery
Remodeling, structural
Evaluation
