山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (1): 21-25.doi: 10.6040/j.issn.1673-3770.0.2015.512

• 论著 • 上一篇    下一篇

伴有嗅觉障碍的慢性鼻-鼻窦炎患者鼻内镜术后嗅觉及生活质量转归的研究

訾晓雪1,赵莉1,金鹏1,屠燕怡1,李昂1,史丽2   

  1. 1. 山东大学医学院, 山东 济南 250012;
    2. 山东大学第二医院耳鼻咽喉头颈外科, 山东 济南 250033
  • 收稿日期:2015-12-04 出版日期:2016-02-16 发布日期:2016-02-16
  • 通讯作者: 史丽. E-mail:shili126@sina.com E-mail:zxx201313669@126.co
  • 作者简介:訾晓雪. E-mail:zxx201313669@126.co
  • 基金资助:
    国家自然科学基金(81441028)

Improvement of the olfaction and quality of life of the chronic rhinosinusitis patients with olfactory disorders.

ZI Xiaoxue1, ZHAO Li1, JIN Peng1, TU Yanyi1, LI Ang1, SHI Li2.   

  1. 1. Shandong University School of Medicine, Jinan 250012, Shandong, China;2.Department of Otolaryngology &Head and Neck Surgery, Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2015-12-04 Online:2016-02-16 Published:2016-02-16

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摘要： 目的 探讨伴有嗅觉障碍的慢性鼻-鼻窦炎(CRS)(伴有/不伴有鼻息肉)患者经鼻内镜手术后嗅觉的转归及其生活质量(QOL)的改善情况。 方法 伴有嗅觉障碍的慢性鼻-鼻窦炎患者44例,其中伴有鼻息肉的患者33例,不伴有鼻息肉的患者11例,于术前行鼻部CT检查(冠状位+矢状位),Lund-Mackay CT评分,并分别于术前、术后4周及12周行T& T嗅觉测试、嗅觉VSA评分及鼻腔鼻窦结局测试(SNOT-20)。 结果 术后4周嗅觉T& T测试59.5%的患者嗅觉有改善,术后12周73.0%的患者嗅觉有改善。术后4周嗅觉vas评分有77.3%的患者嗅觉有改善,术后12周86.4%的患者嗅觉有改善。统计学显示嗅觉T& T测试及嗅觉VAS评分术后4周及12周的得分较术前明显改善(P<0.000 1),术后4周及12周差异无统计学意义(P=0.720,0.147)。SNOT-20评分术前与术后4周及12周均有统计学差异(P<0.000 1),术后4周与12周差异无统计学意义(P=0.055)。术前Lund-Mackay CT评分与T& T嗅觉测试、嗅觉VAS评分呈正相关(r=0.569,P<0.000 1;r=0.782,P<0.000 1)。 结论 鼻内镜术后患者嗅觉及QOL均明显改善,术后4周与12周改善程度差异无统计学意义。患者术前病变范围与嗅觉障碍程度呈正比。

关键词: 鼻内镜外科手术, Lund-Mackay CT评分, 生活质量, SNOT-20评分, 慢性鼻-鼻窦炎, 嗅觉, T&, T嗅觉测试

Abstract: Objective To explore the improvements of olfaction and quality of life(QOL)of the chronic rhinosinusitis(CRS)patients(with / without nasal polyps)with olfactory disorders. Methods 44 CRS patients with olfactory disorders were involved in this study and accepted CT scanning and Lund-Mackay CT score investigation before treatments. VAS score, SNOT-20 score and T&T test were taken before the operation, and 4 weeks and 12 weeks after the operation. Results In the T& T test, there were 59.5% and 73.0% of the patients whose olfaction were improved 4 and 12 weeks after the operation. The improvement rates were 77.3% and 86.4% in the VAS score. There were statistical difference between the pre-operation and post-operative 4 and 12 weeks(P<0.0001)in the T& T test and the VAS score, while the difference between the 4 weeks and 12 weeks after the operation were statistical insignificant(P=0.720,0.147). There was statistical difference between the pre-operation and post-operative 4 and 12 weeks(P<0.000 1)in the SNOT-20 test, while the difference between the 4 weeks and 12 weeks after the operation was statistically insignificant(P=0.055). Lund-Mackay CT score, T & T test, and VAS scores were positively correlated(r=0.569,P<0.000 1;r=0.782,P<0.000 1). Conclusion The olfaction and QOL of the patients significantly improve after endoscopic sinus surgery, and the difference between the 4 weeks and 12 weeks after the operation is statistically insignificant. The extent of the disease in the CRS and the degree of olfactory disorder are positively correlated.

Key words: T test, Endoscopic sinus surgical procedures, operative, Quality of life, Lund-Mackay CT score, Olfaction, Chronic rhinosinusitis, T&, SNOT-20 score

中图分类号: 

  • R765.4
[1] 中华耳鼻咽喉头颈外科杂志编委会,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南(2008年,南昌)[J]. 中华耳鼻咽喉头颈外科杂志,2009,44(1):6.
[2] 左可军,许庚,王德云,等.慢性鼻-鼻窦炎鼻息肉内镜鼻窦手术前后症状与生存质量的评估[J].中华耳鼻咽喉头颈外科杂志,2007,42(4):245-249. ZUO Kejun, XU Geng, WANG Deyun, et al. Postoperative symptoms and life quality assessment of chronic rhinosinusitis patients received endoscopic sinus surgery[J].Chin J Otorhinolaryngol Head Neck Surg, 2007, 42(4):245-249.
[3] Litvack J R, Mace J C, Smith T L. Olfactory function and disease severity in chronic rhinosinusitis[J].Am J Rhinol Allergy, 2009, 23(2):139-144.
[4] Soler Z M, Mace J, Smith T L. Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery[J]. Am J Rhinol, 2008, 22(3):297-301.
[5] Jiang R S, Lu F J, Liang K L, et al. Olfactory function in patients with chronic rhinosinusitis before and after functional endoscopic sinus surgery[J]. Am J Rhinol, 2008, 22(4):445-448.
[6] 许庚,李源.功能性内窥镜真窦外科[J].中华耳鼻咽喉科杂志,1995,30(2):119.
[7] Yamagishi M, Hasegawa S, Suzuki S, et al. Effect of surgicaltreatment of olfactory disturbance caused by localized ethmoiditis[J]. Clin Otolaryngol Allied Sci, 1989, 14(5):405-409.
[8] Pade J, Hummel T. Olfactory function following nasal surgery[J]. Laryngoscope, 2008, 118(7):1260-1264.
[9] Soler Z M, Sauer D A, Mace J C, et al. Ethmoid histopathology does not predict olfactory outcomes after endoscopic sinus surgery[J]. Am J Rhinol Allergy,2010,24(3):281-285.
[10] 边志刚,姜涛,曹志伟,等.鼻窦炎鼻息肉患者鼻内镜手术后嗅觉功能障碍转归因素分析[J].中国耳鼻咽喉颅底外科杂志,2008,14(3):192. BIAN Zhi-gang, JIANG Tao, CAO Zhiwei, et al. Olfactory rehabilitation and relative influencing factors in sinusitis and nasal polyp patients after endoscopic sinus surgery[J]. Chin J Otorhinolaryngol Skull Base Surg, 2008, 14(3):192.
[11] Smith T L. Outcomes research in rhinology: chronic rhinosinusitis[J]. Otorhinolaryngol Relat Spec, 2004,66(2):202-206.
[12] Smith T L, Rhee J D, Loehrl T A, et al. Objective testing and quality-of-life evaluationin surgical candidates with chronic rhinosinusitis[J]. Am J Rhinol, 2003,17(6):351-355.
[13] Wabnitz D A, Nair S, Wormald P J. Correlation between preoperative symptom scores,quality-of-life questionnaires, and staging with computed tomography in patients withchronic rhinosinusitis [J]. Am J Rhinol, 2005, 19(1):91-96.
[14] Michael K,Efthimios S,Gregory T,et al.Predictors of quality of life outcomes in chronic rhinosinusitis after sinus surgery[J]. Eur Arch Otorhinolaryngol, 2014, 271(4):733-741.
[15] Miwa T, Furukawa M, Tsukatani T, et al. Impact of olfactory impairment on quality of life and disability[J]. Arch Otolaryngol Head Neck Surg, 2001, 127(5):497-503.
[16] Ashraf N, Bhattacharyya N. Determination of the“incidental”Lund score for the staging ofchronic rhinosinustis [J ]. Otolaryngol Head Neck Surg, 2001, 125(5):483-486.
[17] 赵红, 魏永祥, 苗旭涛,等. 嗅觉障碍与慢性鼻-鼻窦炎患者鼻腔鼻窦形态的相关性研究[J]. 临床耳鼻咽喉头颈外科杂志,2007, 21(17):771-774. ZHAO Hong, WEI Yongxiang, MIAO Xutao, et al. Correlation between olfactory disorders and morphology of nasal cavity[J]. J Clin Otorhinolaryngol Head Neck Surg, 2007, 21(17):771-774.
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