鼻声反射及鼻阻力检测在结构性鼻炎术后的应用价值  

The application value of nasal reflex and nasal resistance detection after surgery for structural rhinitis

作　　者：王威[1] 沈崇岭 施冬燕[1] 沈柳柳[1] 卫东 陈雪生[1] WANG Wei;SHEN Chongling;SHI Dongyan;SHEN Liuliu;WEI Dong;CHEN Xuesheng(Department of Otorhinolaryngology,Qidong People′s Hospital,Qidong,Jiangsu 226200,China)

机构地区：[1]江苏省启东市人民医院耳鼻喉科,226200

出　　处：《重庆医学》2020年第22期3743-3746,3750,共5页Chongqing medicine

基　　金：江苏省卫生厅科技项目课题(JZ201311);南通市卫健委青年基金(wKZD2018037)。

摘　　要：目的探讨鼻声反射及鼻阻力检测在结构性鼻炎术后的应用价值。方法选取2018年1月至2019年5月该院收治的结构性鼻炎患者60例,分为观察组和对照组,每组30例。两组均行鼻窦CT及鼻内窥镜检查,对照组根据检查结果进行常规手术,观察组于术前进行鼻声反射及鼻阻力检测,根据检测结果调整手术;比较两组术后临床疗效,手术前后鼻通气满意度及心理状况评分[包括视觉模拟量表(VAS)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、鼻内镜(Lund-Kennedy)评分],术后并发症(鼻腔粘连、空鼻症、鼻中隔穿孔、鼻黏膜瘢痕增生)发生情况。比较观察组手术前后鼻声反射[包括最小横截面积(NMCA)、0~7 cm鼻腔容积(NCV0~7)]及鼻阻力[如鼻腔总阻力(NAR)]指标;另通过Spearman系数相关法分析NAR与NMCA、NCV0~7的相关性。结果观察组手术总有效率明显高于对照组(86.67%vs.63.33%,P<0.05)。观察组术后VAS评分明显高于术前及对照组术后,SAS、Lund-Kennedy评分明显低于术前及对照组术后,差异有统计学意义(P<0.05);两组术后SDS评分组内比较明显低于术前(P<0.05)。观察组术后并发症总发生率与对照组比较无明显差异(16.67%vs.26.67%,P>0.05)。观察组术后NMCA、NCV0~7高于术前,NAR低于术前,差异有统计学意义(P<0.05)。经相关性分析,NAR与NMCA、NCV0~7均呈负相关(r=-0.378、-4.523,P<0.05)。结论鼻声反射及鼻阻力检测对结构性鼻炎患者手术有重要的指导意义。Objective To explore the application value of nasal reflex and nasal resistance detection after surgery for structural rhinitis.Methods A total of 60 cases of patients with structural rhinitis admitted to this hospital from January 2018 to May 2019 were selected and divided into the observation group and the control group,with 30 cases in each group.Both groups underwent nasal sinus CT and nasal endoscopy.The control group received routine surgery according to the examination results.The observation group underwent nasal reflex and nasal resistance tests before operation,and the surgery was adjusted according to the examination results.The postoperative clinical efficacy,satisfaction of nasal ventilation and psychological status scores before and after the operation,including visual analog scale(VAS)score,anxiety self-rating scale(SAS)score,depression self-rating scale(SDS)score and Lund Kennedy score,and the occurrence of complications(nasal adhesion,empty nose,perforation of nasal septum and hyperplasia of nasal mucosa)were compared between the two groups.The indexes of nasal reflex[including nasal minimal cross-sectional area(NMCA)and 0-7 cm nasal cavity volume(NCV0-7)]and nasal resistance[total nasal airway resistance(NAR)]were compared before and after operation in the observation group.Additionally,the correlations of NAR to NMCA and NCV0-7 were analysed by Spearman coefficient.Results The total effective rate of surgery in the observation group was significantly higher than that in the control group(86.67%vs.63.33%,P<0.05).The VAS score in the observation group after operation was significantly higher than that before operation and in the control group after the operation,and the SAS score and Lund-Kennedy score were significantly lower than those before operation and in the control group after operation,and there were statistically significant differences(P<0.05).The SDS score in the two groups after operation was significantly lower than that before operation(P<0.05).There was no significant difference i

关 键 词：鼻炎 鼻腔 鼻声反射 鼻阻力 患者满意度 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]