术前VAS症状评分对慢性鼻-鼻窦炎围手术期的指导作用初步研究

发布时间：2018-07-05 02:12

本文选题：鼻窦炎 + 视觉模拟量表　；参考：《临床耳鼻咽喉头颈外科杂志》2016年11期

【摘要】：目的:探讨术前VAS症状评分对慢性鼻-鼻窦炎(CRS)围手术期处理的指导作用。方法:根据收治在相同年资相似经验的高年资医师组不同,将拟行鼻内镜手术的CRS患者分为实验组和对照组。2组患者术前均采用视觉模拟量表(VAS)对CRS患者整体不适及各症状(鼻塞、流涕、头昏头痛、嗅觉减退、鼻痒、喷嚏)进行评分。对术前各症状VAS评分5分者,实验组围手术期严格依据各症状VAS评分采取精准策略,对照组则没有参考VAS评分,仅依据术者临床经验进行围手术期处理。局部麻醉或全身麻醉下进行鼻内镜手术。术后随访6个月和1年,对2组整体不适及各症状进行VAS评分。结果:1实验组随访120例,对照组随访82例。2组患者一般情况、术前整体不适及各症状VAS评分比较差异无统计学意义(P0.05)。2 2组整体不适VAS评分在术后不同时期与术前比较均有显著差异(P0.05)。3各症状中,除嗅觉减退外,鼻塞、流涕、头昏头痛、鼻痒、喷嚏症状VAS评分及患者满意度自评分,2组术后不同时期相比均有显著差异(P0.05)。结论:术前各症状VAS评分,不仅可用于CRS病情及疗效评估,而且对CRS围手术期处理有指导作用,可提高CRS治疗有效率及患者满意度,值得在临床上推广应用。
[Abstract]:Objective: to investigate the effect of preoperative VAS score on perioperative management of chronic rhinosinusitis (CRS). Methods: according to the group of senior doctors with similar experience in the same seniority, Patients with CRS were divided into two groups: experimental group and control group. Visual analogue scale (VAS) was used to evaluate the overall discomfort and symptoms of CRS patients (nasal congestion, runny nose, dizziness headache, decreased olfaction, itching and sneezing). For the patients with 5 points of VAS score before operation, the experimental group adopted accurate strategy according to the VAS score of each symptom during the perioperative period, while the control group did not refer to the VAS score, and only handled the perioperative period according to the clinical experience of the operator. Endoscopic sinus surgery is performed under local or general anesthesia. The patients were followed up for 6 months and 1 year. Results 120 cases were followed up in experiment group 1 and 82 cases in group 2 in control group. There was no significant difference in preoperative overall discomfort and VAS scores between the two groups (P0.05). 2. 2. 2. 2 groups had significant differences in overall discomfort VAS scores at different periods after operation (P0.05). 3 in all symptoms, except olfactory loss, nasal congestion, runny nose, dizziness, headache, dizziness and headache, there was no significant difference between the two groups in terms of overall discomfort and VAS scores (P0.05). The VAS score of nasal itch sneezing symptom and patient satisfaction were significantly different between the two groups in different period after operation (P0.05). Conclusion: the VAS score of every symptom before operation can not only be used to evaluate the condition and curative effect of CRS, but also can guide the treatment of CRS in perioperative period. It can improve the effective rate of CRS treatment and the satisfaction of patients. It is worth popularizing and applying in clinic.
【作者单位】：重庆医科大学附属第一医院耳鼻咽喉科;
【基金】：国家临床重点专科建设项目经费资助(No:卫办医政函[2012]649号) 重庆市自然科学基金(No:cstc2013jcyjA0109),重庆市自然科学基金重点项目(No:cstc2015jcyjB0028) 重庆市卫生计生委科研项目(No:2015HBRC004) 重庆市研究生科研创新项目(No:CYS151210)
【分类号】：R765.9

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