慢性鼻窦炎鼻息肉患者术前术后生存质量的评估及影响因素分析

Evaluation to the quality of life of patients with chronic sinusitis and polyps and analysis of influential factors

目的:对慢性鼻窦炎、鼻息肉患者行功能性鼻窦内镜手术术前术后生存质量进行评估,并分析相关的影响因素,以评价该手术的优越性和指导临床治疗。方法:引用并修改SNOT-20量表,制成慢性鼻窦炎、鼻息肉术前术后生存质量评估量表,均让患者自行填写,随访3个月,随访数据采用统计学方法加以分析。结果:术前术后整体生存质量得分及各维度得分均有明显提高,改善率为88.24%;术前患者感觉对生活影响最大的是:第一维度中鼻塞52.94%,第二维度中记忆力减退18.82%,第三维度中经常担心自己病情8.24%;第四维度中影响社交活动14.12%。术后改善最明显的是:第一维度中鼻塞58.82%,第二维度中记忆力减退10.59%,第三维度中烦躁易怒9.41%,第四维度中影响社交活动的10.59%;术前相关的影响因素是年龄、性别、并发症,术后为年龄、性别、并发症、前期手术史及围术期的处理,分型与生存质量无相关性。结论:功能性鼻窦内镜手术作为治疗慢性鼻窦炎、鼻息肉最有效的临床方法之一,能够明显地改善患者的生存质量。影响生存质量的主要相关因素为:年龄、性别、并发症、前期手术史和围术期处理。

Objeetive：To evaluate how functional endoscopic sinus surgery （FESS） modifies patients symptom profiles and the quality of life and analyze the influential factors. Method：The questionnaires modified according to the SNOT-20 scale were given to 100 patients who underwent sinus surgery at the department of otorhinolaryngology. Result：After a postoperative follow-up of 3 months, an amelioration of the quality of life was achieved in 88.24 % ; the leading influences to life before operation respectively are nasal obstruction （52.94 % ） in the first dimension, decrescence of remembrance （18.82 %） in the second dimension, worrying themselves all day （8. 24 %） in the third dimension, and interference to social intercourse （14.12 % ） in the forth dimension; the leading ameliorations after operation respectively are nasal obstruction （58.82 %） in the first dimension, decrescence of remembrance （10.59 % ） in the second dimension, tantrum （9.41% ） in the third dimension,and interference to social intercourse （10.59 % ） in the forth dimension; the preoperative influential factors are age, sex and complication. The postoperative factors are age, sex, complication, history of previous operation, postoperative treatment and follow-up. Types have no effect on the quality of patient＇s life. Conclusion： As the most effective therapy at present, FESS can improve the quality of life of patients with chronic sinusitis obviously. The major correlative factors are age, sex, complication, history of previous operation, postoperative treatment.