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目的探讨内镜鼻窦手术治疗对慢性鼻-鼻窦炎鼻息肉患者症状与生存质量(quality oflife,QOL)的有效作用及其转变规律。方法通过视觉模拟量表(visual analog scale,VAS)、医学结局研究简表36项健康调查(medical outcome study short-form 36-items health survey,MOS SF-36,简称 SF-36)和鼻腔鼻窦结局测量20条(sino-nasal outcome test-20,SNOT-20)等症状与 QOL 量表,对120例慢性鼻-鼻窦炎鼻息肉患者术前、术后3个月和术后6个月进行前瞻性随访调查与评估,并与200名健康体检者的 QOL 状况进行对比。结果经内镜鼻窦手术治疗,患者术后3个月 VAS 量表的单个症状总分与总体症状、SF-36量表的生理角色与总体健康等部分维度以及 SNOT-20量表的20个条目总分与5大条目总分等指标均开始出现明显好转(P<0.05),术后3～6个月上述指标则无显著提高(P>0.05),术后6个月症状与 QOL 状态较术前均全面改善。SF-36量表显示慢性鼻-鼻窦炎鼻息肉患者与健康体检者差异无统计学意义(P>0.05),但 VAS 量表提示患者嗅觉减退和异常鼻漏等症状依然存在。SNOT-20量表提示慢性鼻-鼻窦炎鼻息肉患者睡眠障碍和异常鼻漏等重要问题仍未解决,与健康体检者相比差异有统计学意义(P<0.05)。结论慢性鼻-鼻窦炎鼻息肉患者内镜鼻窦手术治疗后6个月症状总体上得到解决,生存质量基本恢复常态,但嗅觉减退、异常鼻漏和睡眠障碍等重要问题仍明显存在,有待进一步解决。
Objective To investigate the effective effect of endoscopic sinus surgery on the symptoms and quality of life (QOL) of patients with chronic rhinosinusitis and nasal polyps and its transformation. Methods The visual analog scale (VAS), medical outcome study short-form 36-items health survey (MOS SF-36, SF-36 for short) and nasal sinus outcomes A total of 120 patients with chronic rhinosinusitis and nasal polyposis were preoperatively, 3 months and 6 months after surgery, and 20 symptoms (including SNOT-20) and QOL were measured. Sexual follow-up survey and evaluation, and compared with QOL status of 200 healthy subjects. Results After endoscopic sinus surgery, the scores of individual symptoms and symptoms of VAS, the physiological roles and general health of SF-36 scale and the 20 items of SNOT-20 The scores of the total scores and the total scores of the 5 major items all started to show a significant improvement (P <0.05), and the above indexes did not increase significantly after 3 to 6 months (P> 0.05). After 6 months, the symptoms and QOL status Before surgery are all improved. There was no significant difference between SF-36 and healthy subjects in patients with chronic rhinosinusitis and nasal polyps (P> 0.05). However, VAS showed that patients with hypoxemia and abnormal rhinorrhea still existed. The SNOT-20 scale suggested that important problems such as sleep disorders and abnormal rhinorrhea in patients with chronic rhinosinusitis and nasal polyposis remain unresolved, which is statistically significant compared with healthy subjects (P <0.05). Conclusion The symptoms of patients with chronic rhinosinusitis and nasal polyposis after endoscopic sinus surgery were generally resolved 6 months after treatment, and the quality of life returned to normal, but the important problems such as the loss of smell, abnormal rhinorrhea and sleep disorders still exist and need to be further resolved .