结构性鼻炎患者鼻通气功能的主客观评估  

Evaluation of nasal ventilation in patients with structural rhinitis

作　　者：袁晓培[1] 郭荃容[1] 王旻[1] 邢志敏[1] 余力生[1] 

机构地区：[1]北京大学人民医院耳鼻咽喉科,北京100044

出　　处：《中国耳鼻咽喉头颈外科》2012年第3期143-146,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的对结构性鼻炎患者进行术前鼻通气的主客观评估,为手术提供临床依据。方法结构性鼻炎患者56例,收缩鼻腔前后分别进行鼻堵视觉模拟量表(visualanalogue scale,VAS)评分并分为两组:组1,30例,VAS评分>7;组2,26例,VAS评分<7。组3,正常对照组,24例,VAS评分=0。3组分别进行鼻声反射和鼻阻力测量。记录两侧鼻腔前2个最小截面积(minimum cross-sectional area of nasal cavity,MCA1)、MCA2及其距离前鼻孔距离(the distance between the nostril to minimumcross-sectional area,MD1)、MD2,并分别记算两侧的比值;测量距离前鼻孔5 cm、2～5 cm、5～7 cm的两侧鼻腔容积(nasal volume,V5)、V2-5、V5-7并分别记算两侧的比值;测量双侧鼻腔总阻力(nasal resistance total,RT),计算双侧鼻腔阻力差异比(Rlr)。取收缩鼻腔后数值进行统计学检验。结果 3组MCA1、MD1、MCA2、MD2和RT值均无统计学差异;3组间各比值,除MD1、V5-7差异无统计学意义外,其余比值差异均存在统计学意义;组1测量结果较组2或组3有明显差异,结构异常也更加明显。结论鼻堵严重程度与两侧鼻腔结构异常程度有一定关联;鼻堵VAS评分、鼻声反射和鼻阻力测量应作为结构性鼻炎术前评估的常规手段。OBJECTIVE To evaluate the preoperative subjective and objective nasal ventilation function in patients with structural rhinitis,and to provide clinical evidence for surgery.METHODS Fifty six structural rhinitis patients and twenty-four normal controls whose assessment of nasal obstruction was achieved by visual analogue scale（VAS）before and after decongestion,and divided into two groups： group 1（n =30,VAS score〉7）,group 2（n=26,VAS score〈7） and group 3（control group,n=24,VAS score=0）.Three groups were used objective measurement including rhinomanometry and acoustic rhinometry to measure the first two minimum cross-sectional area of nasal cavity（MCA 1）,MCA 2 of the bilateral nasal cavity and their distances from the nostrils（MD 1）,MD 2,to measure the nasal volume of 5cm,2-5 cm and 5-7 cm from the nostril on both sides of nasal cavity（V 5）,V 2-5,V 5-7,to calculate the ratio of the parameters of the two sides of the nasal cavity respectively,and to measure nasal resistance total（RT）of bilateral nasal cavity and calculate Rlr.Three groups were compared by using statistical test.RESULTS There were no significant statistic difference in MD 1,MCA 2,MD 2 and RT among three groups.All ratios were statistically significant except MD 1,V 5-7 among three groups.Group 1 had obvious difference compared with the other two groups.CONCLUSION It is an association between the degree of nasal obstruction and the abnormal structure of bilateral nasal cavity.VAS score and measurement of rhinomanometry and acoustic rhinometry should be as a conventional method to preoperative patients with structural rhinitis.

关 键 词：鼻炎 疼痛测定 鼻测量 声学 鼻塞 结构性鼻炎 鼻阻力测量法 

分 类 号：R765[医药卫生—耳鼻咽喉科]