山东大学耳鼻喉眼学报 ›› 2026, Vol. 40 ›› Issue (2): 35-43.doi: 10.6040/j.issn.1673-3770.0.2025.012
翟雪纯,边欣,陈敬彩,邓家钰,叶子,杨萍丽
ZHAI Xuechun, BIAN Xin, CHEN Jingcai, DENG Jiayu, YE Zi, YANG Pingli
摘要: 目的 调查慢性额窦炎患者焦虑和抑郁的特征,并探讨额窦炎症状是否是患者焦虑、抑郁的危险因素。 方法 前瞻性地选取126例确诊的慢性额窦炎患者,采用Zung焦虑自评量表(self-rating anxiety scale, SAS)、Zung抑郁自评量表(self-rating depression scale, SDS)、鼻腔鼻窦结局测量22条(sino-nasal outcometest-22, SNOT-22)、视觉模拟量表(visual analogue scale, VAS)、Lund-Mackay CT评价系统、Lund-Kennedy内镜评价系统进行术前心理状态、生活质量和疾病严重程度的评估,并与我国标准常模进行对比,进行统计学分析。 结果 120例有效病例中,术前27.50%的患者有不同程度的焦虑,30.00%的患者有不同程度的抑郁。焦虑抑郁水平明显高于中国常模,差异有统计学意义(t=10.906,P<0.001;t=2.162,P=0.031)。性别、年龄、身高、体质量、是否合并高血压或糖尿病、内镜评分和CT评分对焦虑及抑郁程度无明显影响(P>0.05)。鼻痒、流泪、咳嗽、喘息、头昏头痛、睡眠问题是加重慢性额窦炎患者焦虑的独立危险因素;流涕、眼红肿、睡眠问题是加重慢性额窦炎患者抑郁的独立危险因素(P<0.05)。 结论 慢性额窦炎患者术前焦虑抑郁情绪明显高于普通人群。症状严重程度的加重提高了患者的焦虑抑郁水平,睡眠问题是加重患者焦虑与抑郁的共同独立危险因素。应加强对患者的心理评估和干预,以提高治疗效果和患者的生活质量。
中图分类号:
| [1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国慢性鼻窦炎诊断和治疗指南(2018)[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(2): 81-100. doi: 10.3760/cma.j.issn.1673-0860.2019.02.001 Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and neck Surgery, Subspecialty Group of Rhinology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Chinese guidelines for diagnosis and treatment of chronic rhinosinusitis(2018)[J]. Chin J Otorhinolaryngo Head Neck Surg, 2019, 54(2): 81-100. doi: 10.3760/cma.j.issn.1673-0860.2019.02.001 [2] Sedaghat AR. Chronic Rhinosinusitis[J]. American Family Physician, 2017, 96(8): 500-506 [3] 田勇泉. 耳鼻咽喉头颈外科学[M]. 10版. 北京: 人民卫生出版社, 2024: 193 [4] Steele TO, Mace JC, Smith TL. Does comorbid anxiety predict quality of life outcomes in patients with chronic rhinosinusitis following endoscopic sinus surgery?[J]. Int Forum Allergy Rhinol, 2015, 5(9): 829-838. doi: 10.1002/alr.21543 [5] Scott AJ, Correa AB, Bisby MA, et al. Depression and anxiety trajectories in chronic disease: a systematic review and meta-analysis[J]. Psychother Psychosom, 2023, 92(4): 227-242. doi: 10.1159/000533263 [6] DeConde AS, Mace JC, Alt JA, et al. Longitudinal improvement and stability of the SNOT-22 survey in the evaluation of surgical management for chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2015, 5(3): 233-239. doi: 10.1002/alr.21458 [7] Levy JM, Mace JC, DeConde AS, et al. Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2016, 6(9): 906-913. doi: 10.1002/alr.21776 [8] 田昊, 马有祥, 丁秀勇, 等. 慢性鼻-鼻窦炎患者鼻内镜手术前心理学特征初步分析[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(3): 210-214. doi: 10.3760/cma.j.issn.1673-0860.2015.03.007 TIAN Hao, MA Youyang, DING Xiuyong, et al. Prevalence and psychopathological characteristics of anxiety and depression in patients with chronic rhinosinusitis before endoscopic sinus surgery[J]. Chin J Otorhinolaryngol Head Neck Surg, 2015, 50(3): 210-214. doi: 10.3760/cma.j.issn.1673-0860.2015.03.007 [9] Zung WW. A rating instrument for anxiety disorders[J]. Psychosomatics, 1971, 12(6): 371-379. doi: 10.1016/S0033-3182(71)71479-0 [10] Zung WW, Richards CB, Short MJ. Self-rating depression scale in an outpatient clinic. Further validation of the SDS[J]. Arch Gen Psychiatry, 1965, 13(6): 508-515. doi: 10.1001/archpsyc.1965.01730060026004 [11] Browne JP, Hopkins C, Slack R, et al. Health-related quality of life after polypectomy with and without additional surgery[J]. Laryngoscope, 2006, 116(2): 297-302. doi: 10.1097/01.mlg.0000198338.05826.18 [12] Askar MH, Gamea A, Tomoum MO, et al. Endoscopic management of chronic frontal sinusitis: prospective quality of life analysis[J]. Ann Otol Rhinol Laryngol, 2015, 124(8): 638-648. doi: 10.1177/0003489415573959 [13] Peng L, Wang HF, Wang DF, et al. Screening for psychiatric disorders in chronic rhinosinusitis patients waiting for surgery: a prospective cross-sectional study[J]. Clin Otolaryngol, 2025, 50(1): 88-97. doi: 10.1111/coa.14239 [14] Uhlenbusch N, Löwe B, Härter M, et al. Depression and anxiety in patients with different rare chronic diseases: a cross-sectional study[J]. PLoS One, 2019, 14(2): e0211343. doi: 10.1371/journal.pone.0211343 [15] Gerontoukou EI, Michaelidoy S, Rekleiti M, et al. Investigation of anxiety and depression in patients with chronic diseases[J]. Health Psychol Res, 2015, 3(2): 2123. doi: 10.4081/hpr.2015.2123 [16] Khan NS, Gajula M, Goehring L, et al. Chronic rhinosinusitis and mental health[J]. JAMA Otolaryngol Head Neck Surg, 2024, 150(11): 943-951. doi: 10.1001/jamaoto.2024.2705 [17] 冯丹丹, 黄江菊, 柯霞, 等. 焦虑抑郁程度与慢性鼻窦炎内镜术后主观症状改善的相关性研究[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(9): 830-836. doi: 10.3760/cma.j.cn115330-20200327-00249 FENG Dandan, HUANG Jiangju, KE Xia, et al. The correlation between the degree of anxiety/depression and the improvement of subjective and objective symptoms after functional endoscopic sinus surgery in chronic sinusitis[J]. Chin J Otorhinolaryngol Head Neck Surg, 2020, 55(9): 830-836. doi: 10.3760/cma.j.cn115330-20200327-00249 [18] van Oene CM, van Reij EF, Sprangers MG, et al. Quality-assessment of disease-specific quality of life questionnaires for rhinitis and rhinosinusitis: a systematic review[J]. Allergy, 2007, 62(12): 1359-1371. doi: 10.1111/j.1398-9995.2007.01482.x [19] Dietz de Loos DE, Cornet ME, Hopkins C, et al. Measuring control of disease in Chronic Rhinosinusitis; assessing the correlation between SinoNasal Outcome Test-22 and Visual Analogue Scale item scores[J]. Rhinology, 2023, 61(1): 39-46. doi: 10.4193/Rhin21.275 [20] Schlosser RJ, Gage SE, Kohli P, et al. Burden of illness: a systematic review of depression in chronic rhinosinusitis[J]. Am J Rhinol Allergy, 2016, 30(4): 250-256. doi: 10.2500/ajra.2016.30.4343 [21] Ranford D, Tornari C, Takhar A, et al. Co-morbid anxiety and depression impacts on the correlation between symptom and radiological severity in patients with chronic rhinosinusitis[J]. Rhinology, 2020, 58(6): 568-573. doi: 10.4193/Rhin20.075 [22] Kazi A, West E, Rahman S, et al. Pain catastrophizing and quality of life in adults with chronic rhinosinusitis[J]. Laryngoscope, 2021, 131(9): 1939-1945. doi: 10.1002/lary.29405 [23] Jung YG, Lee JS, Park GC. Does post-infectious olfactory loss affect mood more severely than chronic sinusitis with olfactory loss?[J]. Laryngoscope, 2014, 124(11): 2456-2460. doi: 10.1002/lary.24691 [24] Laidlaw TM, Mullol J, Woessner KM, et al. Chronic rhinosinusitis with nasal polyps and asthma[J]. J Allergy Clin Immunol Pract, 2021, 9(3): 1133-1141. doi: 10.1016/j.jaip.2020.09.063 [25] Wu C, Zhan XJ. Sleep and psychological disorders seriously affect the quality of life of chronic rhinosinusitis patients[J]. Eur Arch Otorhinolaryngol, 2024, 281(7): 3615-3623. doi: 10.1007/s00405-024-08505-3 [26] 吕宝娇, 陈莉莉, 任守艳, 等. 鼻部特异性症状对慢性鼻窦炎术后病人生活质量的影响及负性情绪的中介作用[J]. 全科护理, 2024, 22(20): 3941-3945. doi: 10.12104/j.issn.1674-4748.2024.20.042 [27] Bengtsson C, Lindberg E, Jonsson L, et al. Chronic rhinosinusitis impairs sleep quality: results of the GA2LEN study[J]. Sleep, 2017, 40(1). doi: 10.1093/sleep/zsw021.doi: 10.1093/sleep/zsw021 [28] Vlaykov AN. Application of SNOT-22 test and visual analogue scale in quality of life evaluation in patients with allergic rhinitis[J]. Folia Med(Plovdiv), 2021, 63(3): 337-347. doi: 10.3897/folmed.63.e55256 [29] Chen YP, Jiang J, Xu CZ, et al. Associations between different anatomical types of chronic rhinosinusitis and anxiety and depression[J]. Br J Hosp Med(Lond), 2024, 85(7): 1-9. doi: 10.12968/hmed.2024.0104 [30] DeJean D, Giacomini M, Vanstone M, et al. Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis[J]. Ontario Health Technology Assessment Series, 2013, 13(16): 1-33 |
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