鼻内镜手术对慢性鼻-鼻窦炎鼻息肉患者临床症状和生活质量的影响

Effect of functional endoscopic sinus surgery on symptoms and quality of life in chronic rhinosinusitis

目的探讨鼻内镜手术方式对慢性鼻-鼻窦炎鼻息肉患者症状和生活质量(quality of life,QOL)的影响。方法通过医学结局研究简表36项健康调查(medical outcome study short-form 36-items healt和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)对60例慢性鼻-鼻窦炎鼻息肉患者术前、术后1个月和术后6个月进行随访调查与评估,并从中选取多组鼻窦炎鼻息肉的患者采取不同范围的手术来评估手术方式对改善患者症状和生活质量的影响。结果经鼻内镜手术治疗,患者术后一个月SF-36量表的生理角色、心理健康、情感角色、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2～6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,而手术方式对患者症状和QOL状态影响则无统计学意义(P>0.05)。结论慢性鼻-鼻窦炎鼻息肉患者鼻内镜手术后6个月内症状基本缓解,生活质量基本恢复常态,改良鼻内镜手术对慢性鼻-鼻窦炎鼻息肉患者症状和生活质量的改善与传统鼻内镜手术基本相同。

Objective To evaluate the effect of functional endoscopic sinus surgery and the modus operandi on symptoms and quality of life of patients with chronic rhinosinusitis.Methods Sixty patients with chronic rhinosinusitis and nasal polyps were enrolled by random and their QOL scores were assessed by using QOL instruments including existing SF-36 questionnaires（Chinese version） and SNOT-20 questionnaires,and of them patients of different groups were given different scope surgeries to appraise the impact of the modus operandi on patient′s symptoms and the quality of life.Results In the 1 month follow-up settings, such domains as role physical,mental health,role emotional and general health of SF-36,scores of the total 20 items and the most important 5-item scores of SNOT-20 were markedly improved（P〈0.05）;in the 2-6 month follow-up settings,the above indexes stayed fixed（P〉0.05）;and in the 6-month follow-up settings,indexes of symptoms and QOL status entirely improved from the baseline,and different scope surgeries had no statistical significance on symptoms and QO L.Conclusions On the whole patients undergoing endoscopic sinus surgery have their symptoms relieved and QOL status will be normal on postoperative 6 months.Improved and traditional endoscopic sinus surgery are basically identical on the improvement of the symptoms and QOL.