声反射鼻腔测量与鼻阻力检查在鼻中隔偏曲外科治疗疗效评价中的意义

Significance of acoustic rhinometry and rhinomanometry in the evaluation of surgical treatment of nasal septal deviation

目的探讨声反射鼻腔测量(AR)以及鼻阻力(RM)检查在鼻中隔偏曲手术疗效评价中的应用价值。方法选取待手术的鼻中隔偏曲患者51例,检测鼻腔72侧(其中21例为双侧狭窄)。病变鼻腔使用视觉评分系统(VAS)评价鼻塞主观症状的严重程度。采用AR及RM检查获取鼻气道阻力(NAR)、鼻腔0～5cm容积(NCV0-5)、鼻腔最小横截面积(NMCA)等鼻腔形态学及空气动力学资料,以此作为鼻通气功能评价指标。分别在手术前及术后12周时采集资料。将术前与术后的检查数据进行配对t检验,并对各参数的变化值进行相关分析。结果术前NCV0-5、NMCA、NAR和VAS评分分别为4.07±0.91cm3、0.33±0.08cm2、1.14±0.34kPa.s.L-1和7.36±1.23,与术后(7.29±0.68cm3,0.56±0.08cm2,0.35±0.12kPa.s.L-1,1.14±0.91)比较差异有统计学意义(P<0.01)。ΔNAR与ΔNCV相关系数为0.752(P<0.01),ΔNAR与ΔNMCA相关系数为0.718(P<0.01),ΔNCV与ΔNMCA相关系数为0.529(P<0.01)。分别与ΔNAR、ΔNMCA、ΔNCV的相关检验结果显示,ΔVAS与另外三组数据之间无统计学意义上的相关性。结论AR和RM检查是客观评价鼻中隔偏曲手术疗效的良好指标,但是与主观症状之间缺乏统计学意义上的相关性。

Objective To discuss the significance of acoustic rhinometry （AR） and rhinomanometry （RM） in the evaluation of surgical treatment of nasal septal deviation. Methods Fifty-one patients of nasal septal deviation were recruited, and seventy-two nasal cavities were tested （twenty-one patients with narrowing of double sides）. Visual analogue scale （VAS） was used to estimate the degree of nasal obstruction. AR and RM were used to obtain the data of nasal airway resistance （NAR）, nasal cavity 0-5cm volume （NCV0-5） and nasal minimal cross-sectional area （NMCA）. The data were used to assess the airflow function of nasal cavity. Each patient was tested at the time both before surgery and 12 weeks after surgery. The pre- and post operative data were used to calculate paired t-test by SPSS 16.0, and to disclose the correlation among △NCV, △NMCA, △NAR and △VAS. Results The preoperative data showed that NCV0-5 was 4. 07±0. 91cm^3, NMCA 0. 33±0. 08cm^2, NAR 1. 14±0. 34kPa · s · L^-1, and VAS 7. 36±1. 23; and the postoperative data showed that NCV0-5 was 7. 29±0. 68cm^3, NMCA 0. 56±0.08cm^2 , NAR 0. 35±0. 12kPa · s · L^-1, and VAS 1.14±0. 91. Significant differences existed in NCV0-5, NMCA, NAR and VAS （P〈0.01） between pre- and post operation data. The data of △NAR, △NCV and △NMCA showed significant correlation （P〈0. 01）. The correlation coefficient between △NAR and △NCV was 0. 752; that between △NAR and △NMCA was 0. 718; and that between △NCV and △NMCA was 0. 529 （P〈0.01）. However, all of them had no correlation to △VAS. Conclusion Both AR and RM are appropriate methods to be used in the evaluation of the result of surgical treatment of nasal septal deviation. But the test data have no significant correlation with subjective sensation.