鼻中隔偏曲及慢性鼻窦炎鼻息肉患者的精神心理状态调查

doi:10.6040/j.issn.1673-3770.0.2018.081

摘要/Abstract

摘要： 目的初步调查鼻中隔偏曲(DNS)、慢性鼻窦炎鼻息肉(CRSwNP)患者的精神心理状况,观察其手术前后的心理变化。方法利用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估44例CRSwNP、41例DNS、31例声带息肉患者(对照组)手术前后焦虑、抑郁症状。另取39例健康者作健康对照。结果术前各组的SAS和SDS评分依次为:健康组(36.74±10.39; 38.51±11.30)、对照组(38.52±10.99; 42.26±10.42)、CRSwNP组(42.00±13.54; 43.84±15.44)、DNS组(45.02±10.80; 48.32±11.21)。健康组、对照组与DNS组之间的SAS和SDS评分差异有统计学意义(P<0.01)。CRSwNP组和DNS组的术前、术后的SAS和SDS评分差异有统计学意义(P<0.05)。约1/3的DNS组和CRSwNP组的患者术后仍出现焦虑或抑郁症状。结论 DNS、CRSwNP患者存在一定的焦虑、抑郁症状,术后其评分较术前改善,但约1/3的患者术后仍有焦虑、抑郁症状,必要时应给予心理干预。

关键词: 慢性, 精神心理, 鼻中隔偏曲, 焦虑, 鼻窦炎, 鼻息肉, 抑郁

Abstract: Objective To investigate the psychological status of patients with nasal diseases such as deviated nasal septum(DNS)and chronic rhino-sinusitis with nasal polyps(CRSwNP), and to analyze the changes after surgical intervention. Methods We applied the Zung-self-rating anxiety scale(SAS)and Zung-self-rating depression scale(SDS)as psychological assessment tools. A qualitative study was conducted to analyze the anxiety and depression of 41 patients with DNS, 44 patients with CRSwNP, 31 patients with vocal cord polyp(Control Group)and 39 healthy people. Results The preoperative SAS and SDS scores in different groups were Healthy(36.74±10.39; 38.51±11.30), Control Group(38.52±10.99; 42.26±10.42), CRSwNP(42.00±13.54; 43.84±15.44), DNS(45.02±10.80; 48.32±11.21). The SAS and SDS scores of the DNS group were significantly different from the Control and Healthy groups(P<0.01). The scores could be reduced by surgical treatment(P<0.05). However, almost 1/3rd of patients with nasal diseases reported the same levels of anxiety and depression postoperatively. Conclusion We conclude that the prevalence of anxiety and depression in nasal disease patients is higher than that in the normal population. More attention should be paid to the emotional reactions of inpatients with nasal diseases; psychological interventions against negative emotions should be provided to patients when treating them for somatic diseases.

Key words: Deviation of nasal septum, Rhinosinusitis, chronic, Anxiety, Psychology, Depression, Nasal polyps

中图分类号:

R765.9

陈望兴,赵雪,刘岩,刘悦,金春顺. 鼻中隔偏曲及慢性鼻窦炎鼻息肉患者的精神心理状态调查[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 24-27.

CHEN Wangxing, ZHAO Xue, LIU Yan, LIU Yue, JIN Chunshun. Psychological status of patients with deviated nasal septum or chronic sinusitis with nasal polyps[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 24-27.

参考文献

[1] Alt JA, Smith TL, Mace JC, et al. Sleep quality and disease severity in patients with chronic rhinosinusitis[J]. Laryngoscope, 2013, 123(10):2364-2370.
[2] Nathan RA. The burden of allergic rhinitis[J]. Allergy Asthma Proc, 2007, 28(1):3-9.
[3] 张明圆. 精神科评定量表手册[M].长沙:湖南科学技术出版社,1998: 35-42.
[4] 于德华,吴绍敏,李春波,等. 综合医院住院患者焦虑与抑郁症状调查[J]. 临床精神医学杂志,2004,14(2):69-70. YU Dehua, WU Shaomin, LI Chunbo, et al. The investigation of prevalence of anxiety and depression of inpatients in general hospital[J]. J Clin Psychol Med, 2004, 14(2):69-70.
[5] 李惠春,郑磊磊,滕建荣. 综合性医院住院患者焦虑和抑郁状况分析[J]. 浙江大学学报(医学版),2003,32(4):342-344. LI Huichun, ZHENG Leilei, TENG Jianrong. Analysis the anxiety and depression of inpatients in general hospital[J]. J Zhejiang Univ(Med Sci), 2003, 32(4):342-344.
[6] Bhattacharyya N, Wasan A. Do anxiety and depression confound symptom reporting and diagnostic accuracy in chronic rhinosinusitis?[J]. Ann Otol Rhinol Laryngol, 2008, 117(1):18-23.
[7] Rozanska-Kudelska M, Szulc A, Matulka M, et al. Quality of life,depression and anxiety symptoms in patients with chronic rhinosinusitis with polyps treated by endoscopic sinus surgery[J]. Pol Merkur Lekarski, 2012, 32(190):228-231.
[8] Brandsted R, Sindwani R. Impact of depression on disease-specific symptoms and quality of life in patients with chronic rhinosinusitis[J]. Am J Rhinol, 2007, 21(1):50-54.
[9] Litvack JR, Mace J, Smith TL. Role of depression in outcomes of endoscopic sinus surgery[J]. Otolaryngol Head Neck Surg, 2011, 144(3): 446-451.
[10] Busaba NY, Sin HJ, Salman SD. Impact of gender on clinical presentation of chronic rhinosinusitis with and without polyposis[J]. J Laryngol Otol, 2008, 122(11):1180-1184.
[11] Baumann I, Blumenstock G, Zalaman IM, et al. Impact of gender, age, and comorbidities on quality of life in patients with chronic rhinosinusitis[J]. Rhinology, 2007, 45(4): 268-272.
[12] Lavie P, Gertner R, Zomer J, et al. Breathing disorders in sleep associated with ‘microarousals’ in patients with allergic rhinitis[J]. Acta Otolaryngol, 1981, 92(5-6):529-533.
[13] Craig TJ, Hanks CD, Fisher LH. How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis?[J]. J Allergy Clin Immunol, 2005, 116(6):1264-1266.
[14] Schwentner I, Dejakum K, Schmutzhard J, et al. Does nasal septal surgery improve quality of life?[J]. Acta Otolaryngol, 2006, 126(7):752-757.
[15] Fidan T, Fidan V, Ak M, et al. Neuropsychiatric symptoms, quality of sleep and quality of life in patients diagnosed with nasal septal deviation[J]. Kulak Burun Bogaz Ihtis Derg, 2011, 21(6):312-317.
[16] Mace J, Michael YL, Caelson NE, et al. Effects of depression on quality of life improvement after endoscopic sinus surgery[J]. Laryngoscope, 2008, 118(3):528-534.
[17] 左可军,许庚,王德云,等. 慢性鼻-鼻窦炎鼻息肉内镜鼻窦术前术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 quality of life assessment of chronic rhinosinusitis patents received endoscopic sinus surgery[J]. Chin J Otorhinolaryngol Head Neck Surg, 2007, 42(4):245-249.

相关文章 15

[1]	宋晓宇, 张宇, 李成林, 宋西成. 加速康复外科理念在慢性鼻-鼻窦炎伴鼻息肉手术治疗中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 9-12.
[2]	朱文燕,金新,佘万东,马永驰. 突发性聋30例精神心理状况分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 50-52.
[3]	张汝祥,田昊,马有祥. 鼻内镜鼻窦手术前筛窦颅底高度的CT评估价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 75-77.
[4]	王驰,刘星,孔磊,洪兴和,宁博. 鼻内镜下等离子射频消融术对合并鼻窦炎的小儿腺样体肥大患者疗效及鼻腔黏膜纤毛清除功能的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 78-81.
[5]	吴喜福, 孔维封, 王玮豪, 徐惠清, 戚敏, 杨钦泰. QoR-15在加速康复外科改善慢性鼻-鼻窦炎伴鼻息肉围手术期生活质量评估中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 5-8.
[6]	乔叔芬,杨飞轮,王臻妮,李学忠. YKL-40与慢性鼻-鼻窦炎组织重构的相关性探讨[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 95-99.
[7]	黄芳,郑智娟,谢磊. 突发性聋患者焦虑、抑郁与病情阶段的关系及影响因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 1-6.
[8]	黄远,巴罗,李波,余文兴,杨芳丽,杜进涛. 慢性鼻窦炎鼻息肉中转录因子NKX2-1调控嗜酸性炎症反应的作用[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 17-23.
[9]	黄凯丰. 糖皮质激素短疗程雾化吸入对嗜酸粒细胞性鼻窦炎伴鼻息肉患者鼻部症状及肾上腺皮质功能的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 28-31.
[10]	娄鸿飞,王成硕. 慢性鼻窦炎分型研究进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 10-13.
[11]	李华斌, 赖玉婷. 慢性鼻-鼻窦炎的发病机制及诊疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 4-9.
[12]	张桂敏,林鹏. 慢性鼻-鼻窦炎的内在型:从基础到临床[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 14-17.
[13]	张炜,曾昱菡,余先崧. 慢性鼻窦炎手术前后ECP、EGF、IL-6的水平变化及临床意义[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 63-67.
[14]	于倩倩,关鸽,张念凯,李娜,温君凤,刘婷婷,连媛媛. 鼻腔嗅裂区呼吸道上皮腺瘤样错构瘤的CT影像表现[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 76-81.
[15]	李莹. 慢性鼻窦炎的辨证论治[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 27-30.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed