337例慢性鼻-鼻窦炎患者临床分析

Clinical analysis of 337 cases of chronic rhinosinusitis

目的:探讨慢性鼻-鼻窦炎患者的临床症状和体征情况,为临床治疗提供依据。方法:应用SPSS 18.0软件,采用Personχ2检验、Pearson相关分析和Kruskal-Wallis检验,对337例慢性鼻-鼻窦炎患者的临床资料进行统计学分析。结果:337例患者总VAS评分为(15.9±5.7)分,其中重度症状排名前三位的分别是:鼻塞56例(16.6%)、鼻分泌物或后鼻漏23例(6.8%)、头昏或头痛11例(3.3%),各组间差异有统计学意义(χ2=430.923,P<0.01)。鼻内镜检查评分发现患侧黏膜水肿和分泌物严重程度高于鼻息肉,三组间差异有统计学意义(χ2=128.684,P<0.01)。CT检查评分发现全部阴影排名前三位的部位分别是:上颌窦314侧(46.6%)、窦口鼻道复合体135侧(20.0%)和前筛112侧(16.6%),各组间差异有统计学意义(χ2=803.274,P<0.01)。VAS评分与LundKennedy评分间具有相关性(r=0.516,P<0.05);VAS评分与Lund-Mackay评分间不具有相关性(r=0.213,P>0.05)。结论:临床医师应综合患者的症状、内镜检查及CT检查结果进行合理病情评估,制定个性化的综合治疗方案,严格把握手术适应证,从而提高慢性鼻窦炎的治愈率。

To explore the clinical symptoms and signs situation of chronic rhinosinusitis, for future treat- ment provides the basis. Method：The clinical data of 337 patients with chronic sinusitis were analyzed, using SPSS 18.0 software and conducted Person chi-square test and KruskabWallis test to analysis. Result VAS total score of chronic nasal sinusitis patients is 15.9±5.7. The three top of severe symptoms were： snuffle 56 cases （16.6%）, nasal secretions or postnasal drip 23 cases （6.8% ） and dizziness or headache 11 cases（3.3% ）, there are statistically significant differences （X^2=430. 923,P〈0.01）. Lund-Kennedy score found side with mucosa edema and secretion serious degree higher than nasal polyp, there are statistically significant difference （ X^2 = 128.684, P〈 0.01 ）. Lund- Mackay score showed that the three top parts of all shadow were： maxillary sinus 314 side （46.6%）, OMC 135 side（20.0%） and the former screen 112 side（16.6%）, there are statistically significant differences between groups（X^2 = 803. 274, P〈0.01）. The pearson correlation coefficient r between VAS score and Lund Kennedy score is 0. 516, there are correlation（P〈0.05）. VAS score and Lund- Mackay（r= 0.213 ）, there are not correlation（P〉0.05 ）. Conclusion： Comprehensive treatment should be prodceeded according to different symptom severity and sinus lesions parts with patients, grasped the surgery procedures strictly, so as to improve the cure rate.