主客观评估对慢性鼻-鼻窦炎患者围手术期鼻塞的指导作用  

Guidine role of sunjective and objective assessment in chronic rhinosinusitis patient with nasal congestion during perioperative period

作　　者：肖玲[1,2] 姚红兵[2] 杨玉成[1] XIAO Ling1, 2, YAO Hongbing2, YANG Yucheng1(1 Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; 2 Department of Otolaryngology Head and Neck Surgery, Childen＇s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 401122, Chin)

机构地区：[1]重庆医科大学附属第一医院耳鼻咽喉头颈外科,重庆400016 [2]重庆医科大学附属儿童医院耳鼻咽喉头颈外科儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室,重庆401122

出　　处：《中国耳鼻咽喉头颈外科》2018年第3期139-142,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：重庆市卫生计生委科研项目(2015HBRC004)

摘　　要：目的探讨术前主、客观评估对慢性鼻-鼻窦炎(CRS)患者围手术期鼻塞处理的指导作用。方法对以鼻塞为主诉的CRS患者,因收治在医师组不同,而被分为实验组和对照组。术前两组患者均采用视觉模拟量表(visual analogue scale,VAS)、鼻阻力及鼻声反射对鼻塞进行主、客观评估,并行鼻内镜及鼻窦CT检查评估鼻-鼻窦情况。实验组围手术期严格依据主、客观评估采取个体化处理,对照组仅依据术者的临床经验进行处理。术后6个月和1年随访。结果术前两组患者鼻塞VAS评分、总鼻阻力间相比,差异均无统计学意义(P均>0.05)。术后6个月及1年,两组患者鼻塞VAS评分、总鼻阻力间相比,差异均有统计学意义(P均<0.05)。两组患者术后6个月及1年分别与术前相比,各评分间均有统计学意义(P均<0.05)。术后两组患者疗效评估相比,差异均有统计学意义(P均<0.05)。结论术前鼻塞主、客观评估,不仅可用于CRS鼻塞症状严重程度及治疗效果的评估,两者综合应用并结合鼻内镜及鼻窦CT检查可指导CRS围手术期的个体化诊断和治疗,改善CRS患者鼻塞症状及提高其疗效。OBJECTIVE To assess the guideline role of preoperative subjective and objective assessment on nasal obstruction in chronic rhinosinusitis（CRS） patient during perioperative period. METHODS The patients with CRS who＇s chief complaint was nasal obstruction were divided into experimental group and control group according to different doctors. Visual analog scale, rhinomanometry and acoustic rhinometry were used to assess subjective and objective nasal obstruction, and nasal endoscopy and sinus CT examination were applied to evaluate the condition of nasal cavity and nasal sinuses. Patients were taken corresponding appropriate strategies in experimental group, but conventional empirical measures in control group during perioperative period. Postoperative follow-up were performed in 6 months and 1 year. SPSS21.0 was used for statistical analysis. RESULTS There was no statistical difference in nasal obst ruction symptom score, total rhinomanometr y before operation between experimental group and control group（P〉 0.05）. There were statistical difference between the 2 groups after operation in nasal obstruction symptom score, total rhinomanometry. At the 2 postoperative time points（6 months, 1 year after operation） compared with preoperative period, significant differences were found in the parameters evaluated between the two groups（P〈 0.05）. The curative effect in different postoperative time showed statistical significance（P〈0.05）. CONCLUSION Preoperative subjective and objective assessment for nasal obstruction can be used not only in the evaluation of severity and treatment effect, but also in the guideline of perioperative treatment for CRS combined with nasal endoscopy and sinus CT examination, which can improve nasal obstruction and the treatment effect of CRS.

关 键 词：鼻窦炎 鼻塞 鼻测量 声学 疼痛测定 围手术期医护 鼻阻力 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]