改良Lund-Mackay内镜评分系统在慢性鼻-鼻窦炎中的临床应用

发布时间：2018-01-06 02:05

本文关键词：改良Lund-Mackay内镜评分系统在慢性鼻-鼻窦炎中的临床应用　出处：《中国眼耳鼻喉科杂志》2016年03期 　论文类型：期刊论文

【摘要】：目的探讨改良Lund-Mackay内镜评分系统(MLMES)在慢性鼻-鼻窦炎(CRS)中的临床应用。方法收集57例CRS患者的术前视觉模拟量表(VAS)、鼻腔-鼻窦结局测试22条(SNOT-22)以及LundMackay CT评分(LMS)数据,并录制术中鼻腔、鼻窦情况。术后3个月录制鼻内镜下随访情况,并再次行VAS和SNOT-22评估。所有手术均由同一位医师按照Messerklinger径路进行。由2位耳鼻喉科医师采用双盲法对所有录像进行Lund-Kennedy内镜评分(LKES)及MLMES评分。分析评分者的信度和重测信度,比较主、客观评估方法的相关性,同时分析手术疗效。采用SPSS17.0统计软件进行数据分析。结果 CRS患者术前、术后MLMES的信度良好[组内相关系数(ICC)0.75],且高于LKES。CRS患者术后VAS、SNOT-22、LKES、MLMES均较术前下降,差异均具有统计学意义(t值分别为13.253、15.644、13.609、17.134,P0.05)。Pearson相关性分析显示:CRS患者术前LMS与MLMES、LKES显著相关(r值分别为0.863、0.742,P0.05);术前、术后的MLMES与LKES呈正相关(r值分别为0.670、0.441,P0.05);术前MLMES与VAS、SNOT-22呈正相关(r值分别为0.308、0.400,P0.05),术后MLMES与VAS、SNOT-22呈正相关(r值分别为0.344、0.518,P0.05),术前、术后MLMES变化与VAS、SNOT-22评分变化呈正相关(r值分别为0.275、0.334,P0.05);而LKES与主观评分(VAS、SNOT-22)之间均无相关性(P0.05)。结论 MLMES与客观评估相关性好,与主观评分系统也有一定的相关性,且有很好的信度,可以作为CRS患者评估的客观方法。
[Abstract]:Objective to investigate the application of modified Lund-Mackay endoscopic scoring system (MLMES) in chronic rhinosinusitis. Methods the preoperative visual analogue scale (VAS) was collected from 57 patients with CRS. SNOT-22) and LundMackay CT score were used to record the nasal cavity. Paranasal sinus status. 3 months after the recording of endoscopic follow-up. All the operations were performed by the same physician according to the Messerklinger pathway. All video recordings were performed by two otolaryngologists using a double-blind method. Lund-Kennedy endoscopic score (. LKESs and MLMES scores. Reliability and retest reliability were analyzed. To compare the correlation of subjective and objective evaluation methods, and to analyze the curative effect of operation at the same time. SPSS17.0 statistical software was used to analyze the data. Results the reliability of MLMES in patients with CRS before and after operation was good. [The correlation coefficient was 0.75, and it was significantly higher than that of VASSNOT-22 LKESMLMES in patients with LKES.CRS. The difference was statistically significant (t = 13.253), 15.644 (13.609) and 17.134 (P < 0.05), respectively. The correlation analysis of P0.05and Pearson showed that the correlation between LMS and MLMES-1 LKES was 0.8630.742 before operation. P0.05; Before and after operation, MLMES and LKES were positively correlated with r values of 0.670 ~ 0.441g / g P0.05a, respectively. There was a positive correlation between MLMES and SNOT-22 before operation, MLMES and VAS were 0.308 and 0.400, respectively. The positive correlation between SNOT-22 and VAS was 0.344 卤0.518 and P0.05, respectively. Before and after operation, the changes of MLMES were correlated with VAS. The positive correlation r value of SNOT-22 score was 0.275 卤0.334m (P 0.05); However, there was no correlation between LKES and subjective score (VAS-SNOT-22). Conclusion there is a good correlation between MLMES and objective evaluation. It is also correlated with subjective scoring system and has good reliability. It can be used as an objective method for evaluating CRS patients.
【作者单位】：温州医科大学附属第一医院耳鼻咽喉科;
【分类号】：R765.41
【正文快照】： 慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)在美国的人群患病率达12%[1],在广州市15岁以上人群中的患病率为8.4%[2],并且CRS病程长、易复发,使患者的日常生活受到极大困扰,因而越来越受到研究者的关注。对于药物保守治疗无效的CRS,鼻内镜手术(endoscopic sinus surgery,ESS)

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