SNOT-20、VAS及SF-36量表相结合用于慢性鼻-鼻窦炎患者生存质量的研究  

Study on quality of life in patients with chronic sinusitis as assessed by of SNOT-20,VAS and SF-36

作　　者：张淳[1] 陈婕[1] 江一鸣[1] 李欣[1] 王家东[1] 沈惠风[2] 

机构地区：[1]上海交通大学医学院附属仁济医院耳鼻咽喉-头颈外科,200001 [2]上海交通大学医学院附属仁济医院中医科,200001

出　　处：《重庆医学》2008年第12期1319-1321,1324,共4页Chongqing medicine

摘　　要：目的采用中文版鼻腔鼻窦结局测量20条(the sino-nasal outcome test-20,SNOT-20)、VAS量表及MOS SF-36量表评价84例慢性鼻-鼻窦炎(CRS)患者的生存质量,探讨鼻内镜手术(ednoscopic sinus surgery,ESS)对患者生存质量(quality oflife,QOL)的影响。方法采用患者填写SNOT-20、VAS及SF-36量表的方法,探讨不同程度病变对患者QOL的影响,ESS手术前后QOL的变化及3种量表用于评估CRS患者生存质量过程中的体会。结果(1)CRS患者的QOL在患病后下降:SNOT-20总分、VAS得分和SF-36量表中的躯体疼痛(body pain,BP)、活力(vitality,VT)、社会功能(social function,SF)和情感职能(re-sponsibility of emotion,RE)与对照组比较差异有统计学意义(P<0.05);(2)CRS患者不同分型QOL的比较:CRS三型之间的各分值差异均无统计学意义(P>0.05);(3)术后1周与术前比较鼻症状差异有统计学意义(P<0.05);(4)术后1个月与术后1周比较,BP、VT、SF、RE、鼻相关症状、SNOT-20总分、VAS得分差异有统计学意义(P<0.05);(5)术后1个月与术前比较BP、VT、SF、RE、鼻相关症状、SNOT-20总分、VAS得分差异有统计学意义(P<0.05)。结论(1)生存质量调查表是评估CRS患者术前、术后生存质量的有效手段;(2)不能因为临床分型级别较低而轻视或延迟治疗;(3)SNOT-20、SF-36和VAS量表三者相结合能够较全面地反映CRS患者的生存质量,是一种能够应用于临床的评估CRS疗效的指标之一。Objective Using the Chinese version of the nasal cavity and paranasal sinuses outcome measurement 20（the sino-nasal outcome test-20, SNOT-20）, the visual analogue scale（VAS） and the medical outcome study short form 36 scales（MOS SF-36）, to evaluate the quality of life（QOL） in the patients with chronic sinusitis（CRS） and to investigate the effect of endoscopic sinus surgery（ESS） on QOL. Methods SNOT-20,VAS and the SF-36 scale were used in 84 cases of CRS for assessing the effect of varied lesions on QOL, QOL change before and after ESS and the experience of evaluation process on QOL by three kinds of CRS scale. Results （1） QOL of the patients suffering from CRS declined. The scores of SNOT-20 and VAS,somatic pain（BP）,energy （VT）, social function（SF） and emotional function（RE） in the SF-36 scale had statistical significance compared with the control group（P〈0.05） ; （2）Among the different types of CRS, the QOL score had no statistical significance（P〉0.05） ; （3）To compare 1 week after operation with before operation,the nasal symptoms improved markedly with statistical significance（P〈0.05） ; （4） To compare 1 month after operation with 1 week after operation, there was statistical significance in BP,VT,SF, RE, nasal symptoms, score of SNOT-20 and VAS（P〈0.05）;（5）To compare 1 month after operation with before operation, the difference in BP, VT, SF,RE,nasal symptoms,score of SNOT-20 and VAS were statistically significant（P〈0.05）. Conclusion （1） The life quality questionnaire is an effective mean for assessing preoperative and postoperative quality of life in CRS patients; （2） Even relatively mild sinusitis should not be made light of treatment or delayed in treatment; （3） Combined SNOT-20,SF-36 and VAS scales can reflect the quality of life in CRS patients more fully. It is one of indications assessing the clinical efficacy of CRS.

关 键 词：生存质量 慢性鼻-鼻窦炎 鼻内镜手术 问卷调查 

分 类 号：R765.41[医药卫生—耳鼻咽喉科] R195.4[医药卫生—临床医学]