慢性鼻-鼻窦炎患者症状学特点及内镜鼻窦手术后主要症状的转归

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目的:探讨慢性鼻-鼻窦炎患者的症状学特点及内镜鼻窦手术前后患者主观症状的变化。方法:采用视觉模拟量表对119例慢性鼻-鼻窦炎患者(52例不伴鼻息肉和67例伴鼻息肉)的鼻塞、头昏(头痛)、面部疼痛(胀满感)、嗅觉障碍和鼻分泌物(后鼻漏)5个主要症状进行评分,比较内镜鼻窦手术前和手术后12个月评分的变化。结果:伴和不伴鼻息肉的慢性鼻-鼻窦炎患者出现最多的症状均依次为鼻塞、鼻分泌物(后鼻漏)、头昏(头痛)、面部疼痛(胀满感)和嗅觉障碍。不伴鼻息肉的慢性鼻-鼻窦炎患者较伴鼻息肉者鼻分泌物评分显著增高(P<0.01),但嗅觉障碍评分者显著降低(P<0.01)。在最令人困扰的症状方面,不伴鼻息肉和伴鼻息肉的慢性鼻-鼻窦炎患者分别是鼻分泌物(后鼻漏)和嗅觉障碍。术后伴鼻息肉和不伴鼻息肉的慢性鼻-鼻窦炎患者各个症状出现的频率和评分均较术前显著降低(P<0.01)。结论:伴鼻息肉和不伴鼻息肉的慢性鼻-鼻窦炎患者症状学具有不同的特点,内镜鼻窦手术可以显著改善患者的主观症状,视觉模拟量表评估患者的主观症状是一简便、易于开展的慢性鼻-鼻窦炎疗效主观评估方法。 Objective: To investigate the symptom characteristics of patients with chronic rhinosinusitis and the changes of subjective symptoms before and after endoscopic sinus surgery. Methods: A total of 119 patients with chronic rhinosinusitis (52 without nasal polyps and 67 with nasal polyps) with nasal congestion, dizziness (headache), facial pain (fullness), olfactory dysfunction and Nasal secretions (posterior rhinorrhea) were scored five major symptoms, endoscopic sinus surgery before surgery and 12 months after surgery score changes. RESULTS: The most common symptoms of chronic rhinosinusitis with or without polyps were nasal congestion, nasal discharge (rhinorrhea), dizziness (headache), facial pain (fullness) and olfactory dysfunction. Patients with chronic rhinosinusitis without nasal polyps had a significantly higher nasal discharge score (P <0.01) than those with nasal polyps, but those with olfactory impairment scores were significantly lower (P <0.01). Patients with chronic rhinosinusitis without nasal polyps and nasal polyps are nasal secretions (retro-nasal secretions) and olfactory disorders, respectively, in terms of the most troubling symptoms. The frequency and score of various symptoms of postoperative nasal polyps and non-nasal polyps in patients with chronic rhinosinusitis were significantly lower than those before surgery (P <0.01). CONCLUSIONS: Symptoms of patients with chronic rhinosinusitis with nasal polyps and non-nasal polyps have different characteristics. Endoscopic sinus surgery can significantly improve the subjective symptoms of patients. Visual analog scale assessment of patients with subjective symptoms is a simple and easy To carry out the subjective assessment of the efficacy of chronic rhinosinusitis.
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