鼻呼出气一氧化氮评估伴腺样体肥大慢性鼻窦炎儿童腺样体术后疗效分析  

Nasal exhaled ntric oxide evaluation of adenoidectomy in chronic rhinosinusitis children with adenoid hypertrophy

作　　者：谢菲 慈军 王昌阳 楚士东 管骅 XIE Fei;CI Jun;WANG Changyang;CHU Shidong;GUAN Hua(Department of Otorhinolaryngology,the Affiliated Hangzhou Chest Hospital of Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang,China)

机构地区：[1]浙江大学医学院附属杭州市胸科医院耳鼻咽喉科,浙江杭州310006

出　　处：《中国现代医生》2023年第18期5-8,13,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2020RC097);杭州市农业与社会发展一般项目(20201203B222)。

摘　　要：目的探讨鼻呼出气一氧化氮(nasal exhaled ntric oxide,nNO)浓度伴腺样体肥大的慢性鼻窦炎(chronic rhinosinusitis,CRS)儿童腺样体切除手术前后变化的临床意义。方法选取2019年12月至2021年12月浙江大学医学院附属杭州市胸科医院耳鼻咽喉科69例伴腺样体肥大的CRS儿童纳入病例组,将同期来该院就诊的19例健康儿童纳入对照组,腺样体手术前和术后1个月、2个月进行整体主观病情视觉模拟评分法(visual analogue scale,VAS)评分及n NO浓度测定,分析病例组患儿术前和术后鼻塞、流涕、打鼾与VAS评分;分析病例组患儿nNO浓度、nNO浓度与各指标的相关性,两组术前及术后1个月、术后2个月nNO浓度与病例组患儿术前、术后的整体症状VAS评分和nNO浓度相关性。结果术后1个月,病例组患儿在VAS评分以及鼻塞、流涕和打鼾等症状方面都有显著改善。所有研究对象的n NO浓度水平与腺样体大小和年龄呈负相关,而女性的nNO浓度高于男性。病例组的术前、术后1月和术后2个月的n NO浓度与VAS评分和鼻窦CT扫描Lund-Mackay评分均呈负相关(P<0.05)。与对照组相比,病例组的术前和术后1个月的n NO浓度明显降低(P<0.05)。术后1个月和术后2个月的VAS评分显著低于术前(P<0.05),而术后nNO水平明显升高(P<0.05)。病例组和对照组间的体质量指数(body mass index,BMI)、年龄和性别比较,差异无统计学意义(P>0.05);病例组患儿在术前和术后2个月的nNO浓度差异也无统计学意义(P>0.05)。结论腺样体切除术是伴腺样体肥大的CRS儿童有效的治疗方式,nNO变化可评估CRS儿童病情及腺样体手术的疗效。Objective To investigate the clinical significance of nasal exhaled ntric oxide(nNO)before and after adenoidectomy in children with chronic rhinosinusitis(CRS)with adenoid hypertrophy.Methods From December 2019 to December 2021,69 CRS children with adenoid hypertrophy in the Department of Otorhinolaryngology,a control group of 19 healthy children who visited the same hospital during the same period was included.the affiliated Hangzhou Chest Hospital of Zhejiang University School of Medicine were recruited and included in the case group.The correlation between the concentration of nNO and nNO in the case group of children and each cardboard were compared.The correlation between the concentration of nNO in the two groups at 1 month and 2 months before and after surgery and the overall symptom VAS score and nNO concentration in the case group of children before and after surgery were compared.The visual analogue scale(VAS)scores and nNO values were measured before and 1 month and 2 months after adenoid surgery.The case group’s nasal congestion,rhinorrhea,and snoring symptoms were evaluated before and after the surgery,and their correlation with VAS scores were analyzed.Results One month after surgery,the case group of pediatric patients showed significant improvements in VAS scores,nasal congestion,runny nose,and snoring compared to pre-surgery.nNO levels were negatively correlated with adenoid size and age,with higher levels in females.In the case group,nNO concentrations were negatively correlated with VAS scores and sinus CT scan Lund-Mackay scores before and one month after surgery(P<0.05).nNO levels in the case group were lower before surgery and one month post-surgery compared with the control group(P<0.05).VAS scores at one month and two months post-surgery were lower than pre-surgery(P<0.05),while nNO levels increased post-surgery(P<0.05).There were no significant differences in body mass index(BMI),age,and gender between the case and control groups.The difference in nNO concentrations between pre-surgery

关 键 词：慢性鼻窦炎 鼻呼出气一氧化氮 腺样体切除 儿童 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]