CAJ | 학술논문

目的评估DrafⅢ型额窦手术对鼻腔功能的影响.方法采用前瞻性自身对照研究方法收集2010至2013年首都医科大学附属北京同仁医院30例慢性鼻-鼻窦炎(CRS)患者DrafⅢ型额窦手术前及术后1年的临床资料,并同时给予T&T标准试嗅法进行嗅觉功能检测,进行鼻声反射鼻阻力检查,填写主观症状视觉模拟量表评分(visual analogue scale,VAS)、Wormald电话随访嗅觉主观评分表及Lund-Kennedy内镜评分.30例CRS患者多为伴哮喘及阿司匹林耐受不良等系统致病因素、复发性CRS伴鼻息肉的难治性CRS患者.以SPSS 19.0软件进行统计学分析.结果经DrafⅢ型额窦手术后1年鼻塞症状改善率89.3％ (25/28),完全缓解率57.1％ (16/28);鼻塞改善程度与术前鼻塞严重程度呈正相关(r=0.909,P ＜0.01).术后1年嗅觉功能改善率76.7％ (23/30),其中CRS伴鼻息肉的17例患者改善率可达88.2％.术后嗅觉功能与局部黏膜评分(Lund-Kennedy内镜评分)呈正相关(r =0.671,P＜0.01);而与鼻塞VAS评分无相关性(P =0.349).结论 DrafⅢ型额窦手术能够改善CRS患者尤其是难治性CRS患者术后嗅觉及通气功能.
목적 평고DrafⅢ형액두수술대비강공능적영향.방법 채용전첨성자신대조연구방법수집2010지2013년수도의과대학부속북경동인의원30례만성비-비두염(CRS)환자DrafⅢ형액두수술전급술후1년적림상자료,병동시급여T&T표준시후법진행후각공능검측,진행비성반사비조력검사,전사주관증상시각모의량표평분(visual analogue scale,VAS)、Wormald전화수방후각주관평분표급Lund-Kennedy내경평분.30례CRS환자다위반효천급아사필림내수불량등계통치병인소、복발성CRS반비식육적난치성CRS환자.이SPSS 19.0연건진행통계학분석.결과 경DrafⅢ형액두수술후1년비새증상개선솔89.3％ (25/28),완전완해솔57.1％ (16/28);비새개선정도여술전비새엄중정도정정상관(r=0.909,P ＜0.01).술후1년후각공능개선솔76.7％ (23/30),기중CRS반비식육적17례환자개선솔가체88.2％.술후후각공능여국부점막평분(Lund-Kennedy내경평분)정정상관(r =0.671,P＜0.01);이여비새VAS평분무상관성(P =0.349).결론 DrafⅢ형액두수술능구개선CRS환자우기시난치성CRS환자술후후각급통기공능.
Objective To evaluate the impact of nasal function after Draf Ⅲ frontal sinus surgery (Draf Ⅲ) or the modified endoscopic Lothrop procedure (EMLP).Methods It was a prospective study with self-control.The pre-operative clinical data of 30 patients (from 2010 to 2013,Beijing Tongren Hospital) who underwent Draf Ⅲ surgery,with the testing results of T&T olfactory testing,acoustic rhinometry and rhinomanometry before and 1 year after operation in these patients were collected in this study.All patients complete visual analogue scale (VAS),a telephone follow-up questionnaire of olfactory function used by Wormald and Lund-Kenndy endoscopy score simultaneously with testings above.Most of 30 patients were chronic rhinosinusitis (CRS) with recurrent nasal polyps or systemic risk factors like asthma and aspirin-intolerance,called refractory rhinosinusitis.SPSS 19.0 software was used to analyze the data.Results 89.3％ (25/28) of these patients improved in nasal obstruction 1 year after operation,and the cure rats was 57.1％ (16/28,VAS =0).The level of improvement in nasal obstruction was significantly correlated with pre-operative nasal obstruction severity (r =0.909,P ＜ 0.01).76.7％ (23/30) improved in olfactory function 1 year after operation in all 30 patients,and 88.2％ improved in patients with nasal polyps(CRSwNP).It was also found that olfactory function 1 year after operation was significantly related to Lund-Kennedy endoscopy scores (r =0.671,P ＜0.01),but was not correlated with VAS scores of nasal obstruction (P =0.349).Conclusion The Draf Ⅲ frontal sinus surgery has a significantly positive effect on olfactory and ventilation function post-operatively,especially on refractory rhinosinusitis.