摘要
目的:探讨慢性鼻-鼻窦炎(CRS)患者功能性内镜鼻窦手术(FESS)前后的主客观评估及相关性。方法:对70例术前CRS患者进行主观症状调查[视觉模拟量表(VAS)],并进行客观检查及评分(Lund-Kennedy内镜评分系统及Lund-Mackay CT评分系统)。所有患者FESS术后随访1年,进行术后6个月和12个月的VAS评分及Lund-Kennedy内镜评分。分析各评价方法的相关性及比较手术前后的评价得分。结果:术前鼻塞、鼻分泌物和鼻后滴漏、头面部胀痛感较为突出,经FESS后6、12个月症状改善明显;嗅觉减退和全身不适感术后改善不明显。术前VAS评分与Lund-Mackay CT评分之间呈正相关(r=0.866,P<0.01);术前Lund-Kennedy内镜评分与Lund-Mackay CT评分之间呈正相关(r=0.803,P<0.01);术前VAS评分与Lund-Kennedy内镜评分之间呈正相关(r=0.912,P<0.01)。术后6、12个月VAS总分与术后内镜总分呈正相关(6个月r=0.798,12个月r=0.882);术后12个月的VAS评分中鼻塞、鼻分泌物和鼻后滴漏、头面部胀痛感与Lund-Kennedy(总分)有相关性(r值分别为0.691,0.760,0.751),嗅觉减退和全身不适感与Lund-Kennedy(总分)有相关性(r值分别为0.327,0.438)。术前Lund-Mackay CT总分与术后Lund-Kennedy内镜评分和VAS评分均呈正相关。结论:术前的CT评分、内镜评分和症状评分相关性良好;术后6个月及12个月的内镜和症状评分相关性良好。主客观评价具有较好的相关性,建议对CRS患者进行包括主观症状、影像学和鼻内镜在内的综合评估,全面评价患者的疾病程度。
Objective：To investigate the correlationship between the assessment of subjective and objective in patients with chronic（CRS） rhinosinusitis before and after FESS.Method：Seventy patients with CRS were objectively assessment of VAS and subjectively assessment including the Lund-Kennedy endoscopic scale and Lund-Mackay scale.All patients were followed up 1 year and repeated both the objective and subjective assessment.The correlationships among the different assessments were investigated and the scales of before and after FESS were compared.Result：There were positive correlation between the scale of VAS and Lund-Mackay（r=0.866,P〈0.01）,positive correlation between the scale of Lund-Kennedy and Lund-Mackay（r=0.803,P〈0.01）,and positive correlation between the scale of VAS and Lund-Kennedy（r=0.912,P〈0.01） before the FESS.There were positive correlation between scale of VAS and Lund-Kennedy after 6 and 12 months of FESS with the r-value of 0.798 and 0.882 respectively.The scales of VAS including nasal obstruction,nasal discharge and head pain have positive correlation with the total scale of Lund-Kennedy with r-value of 0.691,0.760 and 0.751 respectively.And the scales of VAS including hyposmia and general malaise have positive correlation with the total scale of Lund-Kennedy with r-value of 0.327,and 0.438 respectively.The scale of Lund-Mackay before has positive correlation with both the scale of Lund-Kennedy and VAS.Conclusion：In patients with CRS,there were correlations among the scales of CT assessment,nasal endoscopic evaluation and VAS before FESS,and there were also correlations between the scales of CT assessment and nasal endoscopic evaluation after 6 and 12 months of FESS.It indicated that to evaluate the patients with CRS properly,the comprehensive assessment including subjective and CT and endoscopic scale should been applied in clinic.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2010年第8期344-347,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻窦炎
鼻息肉
功能性鼻内镜鼻窦手术
rhinosinusitis
nasal polyposis
functional endoscopic sinus surgery
