慢性鼻-鼻窦炎鼻息肉患者的生存质量调查

Quality of life survey on patients with chronic rhinosinusitis and nasal polyps

目的探讨慢性鼻-鼻窦炎鼻息肉(chronic rhinosinusitis with nasal polypsis,CRSwNP)患者的健康相关生存质量(quality of life,QOL)状况。方法通过国内现有的中文版医学结果研究短量36条(the Medical Outcomes Study short Form-36,SF-36)和汉化英文版鼻腔鼻窦结果测量20条(theSino-Nasal Outcome Test-20,SNOT-20),对随机选择的120例 CRSwNP 患者和200名健康体检者进行QOL 的调查与评估,并对汉化后的 SNOT-20量表进行临床和心理学测试。结果汉化 SNOT-20量表的可行性、信度、效度和反应度等性能指标均通过考核。通过 SF-36评估显示:除社会功能和情感角色外,CRSwNP 患者在生理功能、生理角色、躯体疼痛、心理键康、活力和总体健康等6个维度的计分均低于对照组(P 均<0.05);通过汉化 SNOT-20评估显示:患者生理问题、功能限制和情感结果等3个维度的20个条目计分均高于对照组(P 均<0.05),其中影响健康最重要的5个问题依次为必须擤鼻涕、流黏稠鼻涕、缺乏高质量睡眠、头晕和鼻涕向后流。结论 SF-36和汉化 SNOT-20量表能有效调查评估 CRSwNP 患者的 QOL;该病对患者生理功能、生理角色、躯体疼痛、心理健康、活力、总体健康和情感结果等方面有明显的负面影响,临床治疗应着重解决异常分泌物、睡眠障碍和头晕等问题。

Objective To explore the health-related quality of life （QOL） status of patients with chronic rhinosinusitis and nasal polyps. Methods One hundred and twenty patients with chronic rhinosinusitis and nasal polyps and two hundred individuals passing health examination were enrolled by random and their QOL scores were assessed by using QOL instruments including existing SF-36 questionnaire （Chinese version ） and SNOT-20 questionnaire translated into Chinese, of which clinimetric and psychometric properties were tested. Results The feasibility, reliability, validity, and responsibility of Chinese version of SNOT-20 questionnaire all passed the test. By the assessment of SF-36 questionnaire, it revealed that scores of six domains such as physical functioning, role physical, bodily pain, mental health, vitality, and general health from patients with chronic rhinosinusitis and nasal polyps were lower than that of control group except social functioning and role emotional （P 〈 0.05）. It showed by Chinese version of SNOT-20 questionnaire that patients exceeded healthy individuals in the scores of twenty items of three domains including physical problems, functional limitations, and emotional consequences, of which the most five important items affecting health status were respectively need to blow nose, thick nasal discharge, lack of a good night＇s sleep, dizziness, and post-nasal discharge （ P 〈 0.05 ）. Conclusions QOL instruments such as Chinese version of SF-36 and SNOT-20 questionnaires can effectively differentiate the QOL status between patients with chronic rhinosinusitis and nasal polyps and healthy individuals. The negative impact of chronic rhinosinusitis and nasal polyps on patients＇ QOL includes physical functioning, role physical, bodily pain, mental health, vitality, general health, and emotional consequences. The problems of nasal discharge, sleep, and dizziness should be sufficiently emphasized in clinical treatment.