慢性鼻-鼻窦炎患者症状学特点及内镜鼻窦手术后主要症状的转归  

Symptomatic characteristics of chronic rhinosinusitis patients and symptom-specific outcomes after endoscopic sinus surgery

作　　者：万龙[1] 石农[1] 王园园[2] 刘争[2] 崔永华[2] 

机构地区：[1]黄冈市第一医院耳鼻咽喉科,湖北黄冈438000 [2]华中科技大学同济医学院附属同济医院耳鼻咽喉-头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2009年第17期781-783,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨慢性鼻-鼻窦炎患者的症状学特点及内镜鼻窦手术前后患者主观症状的变化。方法:采用视觉模拟量表对119例慢性鼻-鼻窦炎患者(52例不伴鼻息肉和67例伴鼻息肉)的鼻塞、头昏(头痛)、面部疼痛(胀满感)、嗅觉障碍和鼻分泌物(后鼻漏)5个主要症状进行评分,比较内镜鼻窦手术前和手术后12个月评分的变化。结果:伴和不伴鼻息肉的慢性鼻-鼻窦炎患者出现最多的症状均依次为鼻塞、鼻分泌物(后鼻漏)、头昏(头痛)、面部疼痛(胀满感)和嗅觉障碍。不伴鼻息肉的慢性鼻-鼻窦炎患者较伴鼻息肉者鼻分泌物评分显著增高(P<0.01),但嗅觉障碍评分者显著降低(P<0.01)。在最令人困扰的症状方面,不伴鼻息肉和伴鼻息肉的慢性鼻-鼻窦炎患者分别是鼻分泌物(后鼻漏)和嗅觉障碍。术后伴鼻息肉和不伴鼻息肉的慢性鼻-鼻窦炎患者各个症状出现的频率和评分均较术前显著降低(P<0.01)。结论:伴鼻息肉和不伴鼻息肉的慢性鼻-鼻窦炎患者症状学具有不同的特点,内镜鼻窦手术可以显著改善患者的主观症状,视觉模拟量表评估患者的主观症状是一简便、易于开展的慢性鼻-鼻窦炎疗效主观评估方法。Objective：To explore the symptomatic characteristics of chronic rhinosinusitis patients and the report symptom-based outcomes after endoscopic sinus surgery. Method： One hundred and nineteen chronic rhinosinusitis patients underwent endoscopic sinus surgery, including 52 patients of chronic rhinosinusitis without nasal polyps and 67 patients of chronic rhinosinusitis with nasal polyps, were enrolled. Patients were asked to evaluate their symptoms before surgery and 12 months after endoscopic sinus surgery using 10 cm visual analog scale measures. Result.. The most commonly reported symptoms were nasal obstruction, nasal discharge, headache, facial pressure and altered sense of smell. Compared with patients of chronic rhinosinusitis with nasal polyps, patients of chronic rhinosinusitis without nasal polyps reported significantly higher scores of nasal discharge, whereas lower scores of altered sense of smell （P〈0.01 for both）. The most disturbing symptom was nasal discharge and altered sense of smell for chronic rhinosinusitis patients without and with nasal polyps, respectively. After endoscopic sinus surgery, the scores for all studied symptoms were improved greatly in both chronic rhinosinusitis with and without nasal polyps groups（P〈0.01 for all）. Conclusion： Chronic rhinosinusitis patients with and without nasal polyps present different symptomatic characteristics. Endoscopic sinus surgery can improve patient-based syrup toms significantly. Visual analog scale is a simple and powerful tool to evaluate chronic rhinosinusitis symptoms.

关 键 词：鼻窦炎 慢性 症状学 内镜 手术 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]