慢性鼻-鼻窦炎术前肺功能及FeNO检测的临床意义

刘莹; 阎艾慧

doi:10.13201/j.issn.1001-1781.2018.23.005

慢性鼻-鼻窦炎术前肺功能及FeNO检测的临床意义

刘莹,
阎艾慧^,

- 中国医科大学附属第一医院耳鼻咽喉科(沈阳, 110001)

详细信息

通讯作者: 阎艾慧, E-mail:yah567@sina.com

中图分类号: R765.4

收稿日期: 2018-09-20

The application of preoperative pulmonary function and FeNO test in patients with chronic rhinosinusitis

LIU Ying,
YAN Aihui^,

- Department of Otorhinolaryngology, the First Hospital of China Medical University, Shenyang, 110001, China

More Information

Corresponding author: YAN Aihui, E-mail: yah567@sina.com

Received Date: 20 September 2018

摘要

摘要: 目的: 探讨拟行鼻内镜手术的否认支气管哮喘的慢性鼻-鼻窦炎(CRS)患者,术前常规行肺功能、呼出气一氧化氮(FeNO)检测的临床价值。方法: 对232例拟行鼻内镜手术且否认支气管哮喘的CRS(伴或不伴息肉)患者,术前均行肺功能、FeNO检测:①筛查出是否伴有哮喘;②如伴有哮喘者,术前行规范化药物治疗,经呼吸和麻醉医师评估满意后入院行鼻内镜手术,术中麻醉呼吸机监测并记录血氧饱和度(SpO₂)、气道峰压(Ppeak)、呼气末二氧化碳分压(PETCO₂);术后观察并记录患者是否出现喘息、气急、胸闷及咳嗽症状。结果: ①232例患者中,18例诊断为支气管哮喘,阳性率为7.8%。其中17例支气管舒张试验阳性,1例阴性者呼气流量峰值(PEF)改善率为40.4%;18例患者FeNO平均值为46 ppb,其中16例FeNO>25 ppb;40例肺功能检查正常,但FeNO>25 ppb,其中4例FeNO>50 ppb;②232例患者均术中麻醉监测SpO₂>95%、Ppeak<35 cmH₂O、PETCO₂>35 mmHg,术中平稳;③术后18例诊断为哮喘患者中仅有1例第2天晨起出现轻度呼吸困难,听诊散在哮鸣音,支气管扩张剂吸入10 min后症状缓解。232例患者均顺利出院。结论: CRS(伴或不伴息肉)患者鼻内镜手术术前常规筛查肺功能和FeNO检测及规范的围手术期治疗,具有一定的临床意义。
- 鼻窦炎 /
- 肺功能 /
- 呼出气一氧化氮 /
- 哮喘
Abstract: Objective: To explore the application of lung function and exhaled nitric oxide in the evaluation of patients with chronic rhinosinusitis(CRS) with or without polyps who denied bronchial asthma history and planned to undergo endoscopic sinus surgery. Method: Two hundred and thirty-two patients with CRS during April 2016 to April 2018 in our hospital were recruited in this study. All patients accepted lung function and exhaled nitric oxide test before surgery to evaluate whether accompanied with asthma, improvements after standardized drug therapy in patients with asthma. SpO₂, Ppeak and PETCO₂ were monitored and recorded during surgery. Postoperative symptoms of wheezing, shortness of breath, chest tightness and cough were also observed and recorded. Result: ①Of the 232 patients, 18 patients were diagnosed as bronchial asthma, with a positive rate of 7.8%. 17 cases had positive results in bronchodilation test, 1 case was negative whose PEF improvement rate was 40.4%; The mean FeNO of the 18 patients was 46 ppb, of which 16 patients whose FeNO was over 25 ppb; The mean FeNO of 40 cases with normal pulmonary function was over 25ppb, of which 4 cases' FeNO were over 50 ppb;②232 patients' intraopertive anesthesia monitor showed that SpO₂ were greater than 95%, Ppeak were less than 35 cmH₂O, PETCO₂ were greater than 35 mmHg; ③Mild dyspnea occurred in a patients diagnosed as asthma the next morning after surgery. The auscultation was scattered in the wheezing sound, and the symptoms were relieved in 10 minutes after inhalation of salmeterol.Conclusion: Routine screening for lung function and FeNO and standardized perioperative treatment in patients with CRS before nasal endoscopy is useful.
- sinusitis /
- lung function /
- fractional exhaled nitric oxide /
- asthma

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