鼻咽癌内镜术后与鼻部症状相关的生活质量评估  

Evaluation of quality of life related to nasal symptoms in patients undergoing endoscopic surgery for nasopharyngeal carcinoma

作　　者：钟艺杰 邱前辉[1] ZHONG Yijie;QIU Qianhui(Department of Otorhinolaryngology,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China)

机构地区：[1]南方医科大学珠江医院耳鼻咽喉科,广东广州510282

出　　处：《中国耳鼻咽喉颅底外科杂志》2020年第5期502-506,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的了解接受鼻咽癌内镜术后患者与鼻部症状相关的生活质量。方法回顾性分析门诊复诊并配合调查的44例鼻咽癌内镜术后患者临床资料,其中鼻咽恶性肿瘤31例,鼻咽癌放射性颅底骨坏死13例,本研究纳入的44例患者中,无放疗史患者12例(27.3%),一程放疗史患者27例(61.4%),二程放疗史患者5例(11.4%)。对随访的所有患者采用鼻腔鼻窦结果测量22条(SNOT-22)和空鼻综合征6项问卷(ENS6Q)进行鼻部症状及相关的生活质量评价。采用SPSS 24.0软件进行统计学分析。结果 SNOT-22结果显示术后患者嗅觉减退症状最严重,从测量维度上看,患者睡眠相关症状得分较高。ENS6Q的6项条目中鼻痂症状最明显,总得分大于10.5分的患者9例(20.5%)。Kruskal-Wallis检验显示,SNOT-22得分与放疗史有关(P<0.05),而ENS6Q得分与放疗史无相关关系。结论鼻咽癌内镜手术患者尽管鼻腔结构受到不同程度损害,但发生空鼻综合征(ENS)的倾向较小。同时,术后患者均存在不同程度的鼻部症状及睡眠问题,其中有放疗史患者的鼻窦相关生活质量较无放疗史患者差。Objective To realize the quality of life related to nasal symptoms in patients undergoing endoscopic surgery for nasopharyngeal carcinoma.Methods Clinical data of 44 patients who underwent endoscopic surgery for nasopharyngeal lesions and cooperated with our clinical survey were analyzed retrospectively. The follow-up patients included 31 cases of nasopharyngeal malignant tumors and 13 of skull base osteoradionecrosis of nasopharyngeal carcinoma, Among all the 44 patients, 12 cases(27.3%) had no history of radiotherapy, 27(61.4%) received a course of radiotherapy, and 5(11.4%) suffered two courses of radiotherapy. Sinonasal outcome test-22(SNOT-22) and empty nose syndrome 6 item questionnaires(ENS6 Q) were used to evaluate their nasal symptoms and quality of life. Statistical analysis was performed by using SPSS 24.0 software.Results The results of SNOT-22 showed that hyposmia was the most serious syndrome with the highest score for sleep-related symptoms. There were 9 patients(20.5%) with ENS6 Q score higher than 10.5. The symptom of nasal crusting was the most obvious. Kruskal-Wallis test showed that the SNOT-22 score was related to the history of radiotherapy(P<0.05), while the ENS6 Q score was not related to the history of radiotherapy.Conclusion Only a small part of patients undergoing endoscopic skull base surgery are likely to develop empty nose syndrome(ENS),although the nasal cavity structures are damaged to varying degrees. At the same time, patients undergoing endoscopic surgery for nasopharyngeal carcinoma have different degrees of nasal symptoms and sleep disorders. Patients who had received radiotherapy have worse quality of life than those without radiotherapy.

关 键 词：鼻内镜手术 鼻咽肿瘤 生活质量 鼻部症状 空鼻综合征 

分 类 号：R739.63[医药卫生—肿瘤]