嗅觉训练在伴有嗅觉障碍的慢性鼻窦炎术后患者康复中的临床应用

Clinical application of olfactory training in rehabilitation of patients with chronic sinusitis after olfactory disturbance

目的分析嗅觉训练在慢性鼻窦炎引起的嗅觉障碍术后康复中的应用效果,并探讨其作用机制。方法回顾性分析2017年10月~2019年6月于我院行鼻内镜术后仍伴有嗅觉障碍患者86例,采用随机对照和自身对照方法,按随机对照原则、嗅觉障碍程度、治疗时间分组,对所有患者治疗前后进行嗅觉综合评分,并进行统计学分析。结果实验组VAS评分(4.57±3.24)明显高于对照组(3.27±2.79)(P<0.05),且实验组治疗32周VAS评分(4.57±3.24)明显高于治疗16周(3.25±2.92)(P<0.05);治疗后嗅觉下降组和嗅觉丧失组VAS评分(5.25±1.37、2.81±2.14)明显高于治疗前(1.85±0.35、0.78±0.21)(P<0.05),但嗅觉下降组改善更显著(P<0.05);32周后实验组OTT、ODT、OIT、TDI均明显高于对照组(P<0.05),且实验组治疗32周OTT、OIT、TDI明显高于治疗16周(P<0.05)。结论嗅觉训练对鼻内镜术后仍存在嗅觉障碍患者有明显改善,尤其是对保留残余嗅觉的患者改善更明显;延长嗅觉训练时间,可以提高嗅觉障碍疗效。

Objective To analyze the effect of olfactory training in the rehabilitation of patients with olfactory disorders caused by chronic sinusitis,and to explore its mechanism of action.Methods A retrospective analysis of 86 patients with olfactory dysfunction after endoscopic sinus surgery in our hospital from October 2017 to June 2019 was performed using randomized and self-controlled methods.Grouped according to the principle of random control,degree of olfactory disturbance,treatment time,comprehensive olfactory scoring for all patients before and after treatment,and statistical analysis.Results The VAS score of the experimental group(4.57±3.24)was significantly higher than that of the control group(3.27±2.79)(P<0.05),and the VAS score of the experimental group after 32 weeks of treatment(4.57±3.24)was significantly higher than that of 16 weeks(3.25±2.92)(P<0.05);after treatment,VAS scores of olfactory decline group and olfactory loss group(5.25±1.37,2.81±2.14)were significantly higher than those before treatment(1.85±0.35,0.78±0.21)(P<0.05),but the olfactory decreased After 32 weeks of treatment,Ott,ODT,OIT and TDI in the experimental group were significantly higher than those in the control group(P<0.05),and Ott,OIT and TDI in the experimental group at 32 weeks were significantly higher than those in the control group at 16 weeks(P<0.05).Conclusion Olfactory training can significantly improve patients with olfactory dysfunction after nasal endoscopy,especially for patients with residual olfactory sensation.Prolonging olfactory training time can improve the efficacy of olfaction.