120例慢性鼻—鼻窦炎鼻内镜术后随访及生活质量研究

发布时间：2018-12-11 04:49

【摘要】：目的:探讨慢性鼻-鼻窦炎鼻内镜术后定期随访的临床意义及评估鼻内镜手术治疗对慢性鼻-鼻窦炎患者术后生活质量及症状改善情况的影响。方法以2008年南昌慢性鼻-鼻窦炎的诊断和治疗指南为诊断指标,将接受鼻内镜手术治疗的120例慢性鼻-鼻窦炎患者分组，在临床上分为不伴有鼻息肉组和伴有鼻息肉组。对两组患者术后进行定期随访1年，，分析术后随访对手术疗效的影响。其次，评估所有患者术前、术后1、3、6和12个月生活质量状况及主要症状的改善情况,对术前和术后的主要症状和生活质量的评分进行比较。采用视觉模拟量表评估患者的主要症状，对所有患者的4个主要症状评分,分别为鼻塞、鼻分泌物、头痛和嗅觉障碍。采用SNOT-20量表对生活质量状况进行评估。结果不伴鼻息肉组：术后6个月，痊愈36例、好转20例、无效4例；12个月痊愈50例、好转7例、无效3例。伴鼻息肉组：术后6个月，痊愈30例、好转27例、无效3例；12个月痊愈37例、好转20例、无效3例。两组病情转归差异具有统计学意义。对120例慢性鼻窦炎患者经鼻内镜手术治疗后，分别在术后第1、3、6、12个月对主要症状评分进行评估，得分明显下降,较术前均明显下降(P均0.01)。术后第1、3、6、12个月主要症状评分与术前比较差异均有统计学意义。20个条目和5大条目评分与术前比较均明显下降(P均0.01)。术后第1、3、6、12个月的20个条目和5大条目的评分与术前比较差异均有统计学意义。结论鼻内窥镜术后进行定期随访换药及综合治疗是必不可少的重要环节，术后进行定期规律的随访换药及综合治疗可以显著提高手术疗效，术后进行定期规律的鼻内镜随访是提高手术疗效、减少CRS复发的关键。为提高治愈率，手术后加强随访换药及后期综合治疗，与手术具有同等重要的作用。其次，鼻内镜手术可以使慢性鼻窦炎患者的症状和生活质量得到明显改善。鼻内镜手术是治疗慢性鼻-鼻窦炎的有效方法。
[Abstract]:Objective: to investigate the clinical significance of chronic rhinosinusitis and to evaluate the effect of endoscopic sinus surgery on the quality of life and the improvement of symptoms in patients with chronic rhinosinusitis. Methods 120 patients with chronic rhinosinusitis who received endoscopic sinus surgery were divided into two groups according to the diagnosis and treatment guidelines of Nanchang chronic rhinosinusitis in 2008. The patients were divided into two groups: the group without nasal polyps and the group with nasal polyps. Two groups of patients were regularly followed up for 1 year, and the effect of postoperative follow-up on the outcome of the operation was analyzed. Secondly, the quality of life (QOL) and the improvement of major symptoms were evaluated in all patients before and after operation, and the scores of major symptoms and quality of life were compared before and after operation. The main symptoms of the patients were evaluated by visual analogue scale. The four main symptoms of all patients were nasal obstruction, nasal secretion, headache and olfactory disorder. The quality of life (QOL) was evaluated with SNOT-20 scale. Results in the group without nasal polyps, 36 cases were cured, 20 cases were improved, 4 cases were ineffective, 50 cases were cured at 12 months, 7 cases were improved, and 3 cases were ineffective. In the nasal polyp group, 30 cases were cured, 27 cases were improved, 3 cases were ineffective, 37 cases were cured at 12 months, 20 cases were improved, and 3 cases were ineffective. The difference between the two groups was statistically significant. The main symptom scores of 120 patients with chronic sinusitis were evaluated at the 1st and 12th month after endoscopic sinus surgery. The scores were significantly lower than those before operation (all P 0.01). There were significant differences in the scores of major symptoms between 6 and 12 months after operation, and the scores of 20 items and 5 items were significantly decreased compared with those before operation (P 0.01). The scores of 20 items and 5 items in 12 months after operation were significantly different from those before operation. Conclusion it is necessary and important to carry out regular follow up and comprehensive treatment after nasal endoscopy. The regular follow-up and comprehensive treatment can significantly improve the curative effect of the operation. Regular endoscopic follow-up is the key to improve the curative effect and reduce the recurrence of CRS. In order to improve the cure rate, it is of the same importance as the operation to strengthen the follow-up and dressing change and the later comprehensive treatment. Second, endoscopic sinus surgery can significantly improve the symptoms and quality of life in patients with chronic sinusitis. Endoscopic sinus surgery is an effective method for the treatment of chronic rhinosinusitis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R765.9

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