慢性鼻窦炎伴哮喘鼻内镜术后哮喘临床控制状况及生活质量分析

郭佳星; 阎艾慧

doi:10.13201/j.issn.1001-1781.2019.08.007

慢性鼻窦炎伴哮喘鼻内镜术后哮喘临床控制状况及生活质量分析

郭佳星,
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: R765.2

收稿日期: 2019-03-26

Clinical control status and quality of life in patients with chronic rhinosinusitis and asthma after endoscopic surgery

GUO Jiaxing,
YAN Aihui^,

- 1 Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China;

More Information

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

Received Date: 26 March 2019

摘要

摘要: 目的:探讨慢性鼻窦炎(CRS)伴哮喘的患者鼻内镜手术后的哮喘临床控制状况及生活质量的改变。方法:36例行鼻内镜手术治疗的CRS伴哮喘患者,在术前均行规范化药物治疗,经呼吸科和麻醉科医生评估合格后入院行鼻内镜手术,术中严密监测患者情况,术后观察并记录患者各项评估指标。将患者术前与术后半年、1年的各项观察指标进行比较。结果:①哮喘控制量表评分:哮喘完全控制的比例由术前的8.33%,提高至术后半年30.56%,1年27.78%,术前与术后半年及1年比较,差异均有统计学意义(P<0.05)。②哮喘生活质量问卷:患者术后评估生活质量的各项指标除对刺激源的反应外,活动受限、哮喘症状、心理状况及对自身健康的重视程度均有改善,差异有统计学意义(P<0.05)。③术后半年、1年分别有47.22%和41.67%的患者哮喘用药情况得到改善,2组比较差异无统计学意义(P>0.05)。④呼出气一氧化氮指标术后半年、1年均较术前降低(P<0.05)。⑤术前、术后的肺功能指标无明显变化(P>0.05)。结论:CRS伴哮喘患者在以鼻内镜手术为主的综合治疗下,提高生活质量的同时也可改善患者哮喘症状控制及用药情况,对控制哮喘的发展,在临床疗效上具有积极作用。
- 鼻窦炎 /
- 哮喘 /
- 鼻内镜手术
Abstract: Objective: The aim of this study is to investigate the clinical control status and quality of life of patients with chronic sinusitis and asthma after endoscopic surgery. Method: A prospective study of 36 patients with chronic rhinosinusitis and asthma who had endoscopic surgery. All patients underwent standardized drug therapy before operation. After evaluation by the respiratory and anesthesiologists, they were admitted to the hospital for endoscopic surgery. The patients were closely monitored during the operation, and the patients were observed and recorded. Self-control was performed to compare the observational indexes of the patients for half a year and one year after surgery. Result: ①The Asthma Control Scale (ACT) score showed that the proportion of complete control of asthma increased from 8.33% before surgery to 30.56% in the first half of the year and 27.78% in 1 year, which was significantly improved (P<0.05). ②Asthma Quality of Life Questionnaire(AQLQ) showedthatthe indicators of postoperative quality except the response to the stimulus, limited activity, asthma symptoms, psychological status and concern for their own health are all have statistically significant (P<0.05). ③In the first half of the year, there were 47.22%, in 1 year, 41.67% of the patients had improved asthma medication. There was no difference between the two groups (P>0.05). ④The exhaled nitric oxide index was decreased in the first half of the year and in the first year after operation. ⑤There was no significant change in lung function indexes before and after operation (P>0.05). Conclusion: In patients with chronic sinusitis and asthma, under the comprehensive treatment of endoscopic surgery, improving the quality of life of patients can also improve the control of asthma symptoms and medication, control the development of asthma, and have a positive effect on clinical efficacy.
- chronic rhinosinusitis /
- asthma /
- endoscopic surgery

HTML全文

参考文献(17)

[1]	陈枫虹,史剑波.鼻科医生为什么要关注慢性鼻-鼻窦炎患者的下呼吸道[J].临床耳鼻咽喉头颈外科杂志,2015,29(5):478-482.
[2]	TAY T R,HEW M. Comorbid "treatable traits" in difficult asthma:Current evidence and clinical evaluation[J].Allergy,2018,73:1369-1382.
[3]	DUNLOP G,SCADDING G K,LUND V J. The effect of endoscopic sinus surgery on asthma:management of patients with chronicrhinosinusitis,nasal polyposis,and asthma[J].Am J Rhinol,1999,13:261-265.
[4]	中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2016版)[J].中华结核与呼吸杂志,2016,39(9):675-698.
[5]	AVALLONE K M,MCLEISH A C,LUBERTO C M,et al. Anxiety sensitivity,asthma control,and quality of life in adults with asthma[J].J Asthma,2012,49:57-62.
[6]	张海娇,赵芝焕.支气管哮喘生命质量量表[J].医学综述,2010,16(23):3599-3602.
[7]	SOLER Z M,JONES R,SCHLOSSER R J,et al.Sino-Nasal outcome test-22 outcomes after sinus surgery:A systematic review and meta-analysis[J].Laryngoscope,2018,128:581-592.
[8]	NAKAYAMA T,YOSHIKAWA M,ASAKA D,et al.Mucosal eosinophilia and recurrence of nasal polyps-new classification of chronic rhinosinusitis[J].Rhinology,2011,49:392-396.
[9]	EK A,MIDDELVELD R J,BERTILSSON H,et al. Chronic rhinosinusitis in asthma is a negative predictor of quality of life:results from the SwedishGA(2) LEN survey[J].Allergy,2013,68:1314-1321.
[10]	GIAVINA B P,AUN M V,AGONDI R C,et al.United airway disease:current perspectives[J].J Asthma Allergy,2016,18:93-100.
[11]	HUANG Z,ZHOU B,CUI S,et al.The role of upper and lower airway patency in chronic rhinosinusitis with nasal polyps and asthma[J].Laryngoscope,2012,123:569-573.
[12]	YANG H J,LOSAVIO P S,ENGEN P A,et al. Association of nasal microbiome and asthma control in patients with chronic rhinosinusitis[J].Clin Exp Allergy,2018,48:1744-1747.
[13]	MARPLE B F. Allergic rhinitis and inflammatory airway disease:interactions within the unified airspace[J].Am J Rhinol Allergy,2010,24:249-254.
[14]	ABUZEID W M,VAKIL M,LIN J,et al. Endoscopic modified Lothrop procedure after failure of primary endoscopic sinus surgery:a meta-analysis[J].Int Forum Allergy Rhinol,2018,8:605-613.
[15]	VASHISHTA R,SOLER Z M,NGUYEN S A,et al. A systematic review and meta-analysis of asthma outcomes following endoscopic sinus surgery for chronic rhinosinusitis[J].Int Forum Allergy Rhinol,2013,3:788-794.
[16]	HUANG Z,ZHOU B,ZHANG Q,et al. The role of upper and lower airway patency in chronic rhinosinusitis with nasal polyps and asthma[J].Laryngoscope,2013,123:569-573.
[17]	BRESCIANI M,PARADIS L,DES ROCHES A,et al.Rhinosinusitis in severe asthma[J].J Allergy Clin Immunol,2001,107:73-80.