目的探讨慢性鼻-鼻窦炎鼻息肉(chronic rhinosinusitis with nasal polypsis,CRSwNP)患者的健康相关生存质量(quality of life,QOL)状况。方法通过国内现有的中文版医学结果研究短量36条(the Medical Outcomes Study short Form-36,SF-...目的探讨慢性鼻-鼻窦炎鼻息肉(chronic rhinosinusitis with nasal polypsis,CRSwNP)患者的健康相关生存质量(quality of life,QOL)状况。方法通过国内现有的中文版医学结果研究短量36条(the Medical Outcomes Study short Form-36,SF-36)和汉化英文版鼻腔鼻窦结果测量20条(theSino-Nasal Outcome Test-20,SNOT-20),对随机选择的120例 CRSwNP 患者和200名健康体检者进行QOL 的调查与评估,并对汉化后的 SNOT-20量表进行临床和心理学测试。结果汉化 SNOT-20量表的可行性、信度、效度和反应度等性能指标均通过考核。通过 SF-36评估显示:除社会功能和情感角色外,CRSwNP 患者在生理功能、生理角色、躯体疼痛、心理键康、活力和总体健康等6个维度的计分均低于对照组(P 均<0.05);通过汉化 SNOT-20评估显示:患者生理问题、功能限制和情感结果等3个维度的20个条目计分均高于对照组(P 均<0.05),其中影响健康最重要的5个问题依次为必须擤鼻涕、流黏稠鼻涕、缺乏高质量睡眠、头晕和鼻涕向后流。结论 SF-36和汉化 SNOT-20量表能有效调查评估 CRSwNP 患者的 QOL;该病对患者生理功能、生理角色、躯体疼痛、心理健康、活力、总体健康和情感结果等方面有明显的负面影响,临床治疗应着重解决异常分泌物、睡眠障碍和头晕等问题。展开更多
Background:Enhanced recovery after surgery (ERAS) protocols are a series of perioperative care to optimize preoperative preparation, prevent postoperative complications, minimize stress, and speed up recovery. This st...Background:Enhanced recovery after surgery (ERAS) protocols are a series of perioperative care to optimize preoperative preparation, prevent postoperative complications, minimize stress, and speed up recovery. This study aimed to assess the impact of ERAS protocols for functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).Methods:One hundred and two patients with CRSwNP undergoing FESS were randomly divided into the ERAS group and the control group. The outcomes of the Self-Rating Anxiety Scale (SAS), Visual Analogue Scale (VAS), Medical Outcomes Study Sleep Scale (MOS-SS) and Kolcaba Comfort Scale Questionnaire (GCQ) were determined in both groups. The serum levels of C-reactive protein (CRP) were compared preoperatively and 24 hours postoperatively.Results:The ERAS group had a significantly better SAS scores than did the control group (28 [24, 35] vs. 43 [42, 47], Z=5.968, P<0.001). The rhinalgia and headache scores at 2, 24 and 48 hours postoperatively were lower in the ERAS group than that in the control group (all P < 0.001). The outcomes of the MOS-SS (43 [42, 39] vs. 28 [22, 35], Z= 7.071, P < 0.001) and GCQ (76 [68, 87] vs. 64 [50, 75], Z= 4.806, P < 0.001) were significantly different between the two groups. No significant difference was found in the preoperative CRP levels between the two groups (1.3 [0.6, 2.8] vs. 0.5 [0.5, 1.2], Z = 3.049, P > 0.05);However, the CRP level in 24 hours postoperatively was significantly lower in the ERAS group than that in the control group (2.5 [1.4, 3.9] vs. 6.6 [3.8, 9.0], Z = 5.027, P < 0.001). The incidence rates of complications, such as nausea/emesis (χ^2=0.343, P>0.05), hemorrhage, aspiration and tumble, were not increased in the ERAS group compared with those in the control group. The ERAS group had a significantly shorter length of hospital stay (5 [4, 5] days vs. 8 [8,9] days, Z=8.939, P<0.001) and hospitalization expenses ($ 2670 [2375, 2740] vs. $3129 [3116, 3456], Z=8.514, P<0.001).Conclusions:ERAS pr展开更多
Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be div...Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS(ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.展开更多
目的探讨慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)院前干预措施在其术后加速康复(enhanced recovery after surgery,ERAS)中的应用价值。方法选取符合纳入和排除标准的128例CRSwNP患者,随机分为干预组(60...目的探讨慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)院前干预措施在其术后加速康复(enhanced recovery after surgery,ERAS)中的应用价值。方法选取符合纳入和排除标准的128例CRSwNP患者,随机分为干预组(60例)和对照组(68例)。干预组根据门诊健康评估、多学科协作(multidisciplinary team,MDT)及个体差异采用针对性预康复处理,对照组门诊评估后在院完善常规术前准备,围术期两组均实施常规ERAS方案。依据焦虑抑郁量表(hospital anxiety and depression scale,HADS)、医学结局研究睡眠量表(medical outcomes study sleep scale,MOS-SS)、视觉模拟量表(visual analogue scale,VAS),对比干预组患者心理干预前后的情绪状态、两组患者术后睡眠质量及不适症状程度。比较两组患者术中出血量、手术时间、术前在院等待时间、住院总时间及术后并发症发生率。结果干预组患者心理干预前后HADS评分为(6.10±1.39)分、(3.18±0.79)分,干预组和对照组术后MOS-SS评分为(47.77±2.98)分、(37.69±2.27)分,差异均有统计学意义(P<0.05);干预组术后鼻痛、口干、吞咽障碍、呼吸障碍的VAS评分均低于对照组,差异均有统计学意义(P<0.05);干预组术中出血量、手术时间、术前在院等待时间、住院总时间均少于对照组,差异均有统计学意义(P<0.05)。结论个体化的院前干预措施,可以为CRSwNP手术创造良好的机体条件,减少患者围术期的生理和心理应激,改善就医体验,促进术后康复,进一步完善CRSwNP的ERAS方案。展开更多
基金grants from the National Natural Science Foundation of China (No.81670912)Science and Technology Planning Project of Guangdong Province (No.2014A020212138)Industry-Academic Cooperation Foundation of Guangzhou (No. 201704030046).
文摘Background:Enhanced recovery after surgery (ERAS) protocols are a series of perioperative care to optimize preoperative preparation, prevent postoperative complications, minimize stress, and speed up recovery. This study aimed to assess the impact of ERAS protocols for functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).Methods:One hundred and two patients with CRSwNP undergoing FESS were randomly divided into the ERAS group and the control group. The outcomes of the Self-Rating Anxiety Scale (SAS), Visual Analogue Scale (VAS), Medical Outcomes Study Sleep Scale (MOS-SS) and Kolcaba Comfort Scale Questionnaire (GCQ) were determined in both groups. The serum levels of C-reactive protein (CRP) were compared preoperatively and 24 hours postoperatively.Results:The ERAS group had a significantly better SAS scores than did the control group (28 [24, 35] vs. 43 [42, 47], Z=5.968, P<0.001). The rhinalgia and headache scores at 2, 24 and 48 hours postoperatively were lower in the ERAS group than that in the control group (all P < 0.001). The outcomes of the MOS-SS (43 [42, 39] vs. 28 [22, 35], Z= 7.071, P < 0.001) and GCQ (76 [68, 87] vs. 64 [50, 75], Z= 4.806, P < 0.001) were significantly different between the two groups. No significant difference was found in the preoperative CRP levels between the two groups (1.3 [0.6, 2.8] vs. 0.5 [0.5, 1.2], Z = 3.049, P > 0.05);However, the CRP level in 24 hours postoperatively was significantly lower in the ERAS group than that in the control group (2.5 [1.4, 3.9] vs. 6.6 [3.8, 9.0], Z = 5.027, P < 0.001). The incidence rates of complications, such as nausea/emesis (χ^2=0.343, P>0.05), hemorrhage, aspiration and tumble, were not increased in the ERAS group compared with those in the control group. The ERAS group had a significantly shorter length of hospital stay (5 [4, 5] days vs. 8 [8,9] days, Z=8.939, P<0.001) and hospitalization expenses ($ 2670 [2375, 2740] vs. $3129 [3116, 3456], Z=8.514, P<0.001).Conclusions:ERAS pr
文摘Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS(ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.
文摘目的探讨慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)院前干预措施在其术后加速康复(enhanced recovery after surgery,ERAS)中的应用价值。方法选取符合纳入和排除标准的128例CRSwNP患者,随机分为干预组(60例)和对照组(68例)。干预组根据门诊健康评估、多学科协作(multidisciplinary team,MDT)及个体差异采用针对性预康复处理,对照组门诊评估后在院完善常规术前准备,围术期两组均实施常规ERAS方案。依据焦虑抑郁量表(hospital anxiety and depression scale,HADS)、医学结局研究睡眠量表(medical outcomes study sleep scale,MOS-SS)、视觉模拟量表(visual analogue scale,VAS),对比干预组患者心理干预前后的情绪状态、两组患者术后睡眠质量及不适症状程度。比较两组患者术中出血量、手术时间、术前在院等待时间、住院总时间及术后并发症发生率。结果干预组患者心理干预前后HADS评分为(6.10±1.39)分、(3.18±0.79)分,干预组和对照组术后MOS-SS评分为(47.77±2.98)分、(37.69±2.27)分,差异均有统计学意义(P<0.05);干预组术后鼻痛、口干、吞咽障碍、呼吸障碍的VAS评分均低于对照组,差异均有统计学意义(P<0.05);干预组术中出血量、手术时间、术前在院等待时间、住院总时间均少于对照组,差异均有统计学意义(P<0.05)。结论个体化的院前干预措施,可以为CRSwNP手术创造良好的机体条件,减少患者围术期的生理和心理应激,改善就医体验,促进术后康复,进一步完善CRSwNP的ERAS方案。
