Objective assessment of nasal function changes after revision endoscopic sinus surgery in patients with recurrent sinusitis
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摘要: 目的 探讨复发性鼻窦炎患者修正性鼻内镜手术后鼻功能改变的客观评估体系。方法 复发性鼻窦炎患者60例，均行修正性鼻内镜手术，分别于术前、术后3个月、6个月、12个月行Lund-Kennedy鼻内镜评分及Lund-Mackay鼻窦CT评分，于术前、术后6个月、12个月采用糖精实验法评估鼻黏膜纤毛运动功能(鼻黏膜纤毛运动速率)，并分析手术前后各客观评估指标的相关性。结果 术后3、6、12个月患者的Lund-Kennedy鼻内镜评分和Lund-Mackay鼻窦CT评分较术前明显降低(P < 0.05);术后6、12个月患者的Lund-Kennedy鼻内镜评分和Lund-Mackay鼻窦CT评分较术后3个月明显降低(P < 0.05);术后12个月患者的Lund-Kennedy鼻内镜评分和Lund-Mackay鼻窦CT评分较术后6个月明显降低(P < 0.05)。术后6、12个月患者的鼻黏膜纤毛运动速率较术前明显降低(P < 0.05);术后12个月患者的鼻黏膜纤毛运动速率较术后6个月明显降低(P < 0.05)。术前、术后3个月、术后6个月、术后12个月患者的Lund-Kennedy鼻内镜评分和Lund-Mackay鼻窦CT评分均呈正相关(P < 0.05);术前、术后6个月、术后12个月患者的Lund-Kennedy鼻内镜评分和鼻黏膜纤毛运动速率均呈负相关(P < 0.05);术前、术后6个月、术后12个月患者的Lund-Mackay鼻窦CT评分和鼻黏膜纤毛运动速率均呈负相关(P < 0.05)。结论 复发性鼻窦炎患者修正性鼻内镜手术前后Lund-Kennedy鼻内镜评分、Lund-Mackay鼻窦CT评分、鼻黏膜纤毛运动速率之间具有良好的相关性，本研究建立了以这3种指标为主体的评估鼻功能改变的客观评估体系。Abstract: Objective To investigate the objective evaluation system of nasal function changes in patients with recurrent sinusitis after revision endoscopic sinus surgery.Method Sixty patients with recurrent sinusitis underwent revision endoscopic sinus surgery. The Lund-Kennedy endoscopic sinus score and Lund-Mackay paranasal sinus CT score were performed before surgery, 3, 6 and 12 months after surgery. The saccharin test was used to evaluate the nasal mucosa ciliary moving function(nasal mucosal ciliary motor velocity) before surgery, 6 and 12 months after surgery. The correlation of objective evaluation indexes before and after surgery was analyzed.Result The Lund-Kennedy endoscopic sinus score and Lund-Mackay paranasal sinus CT score of patients 3, 6, 12 months after surgery were lower than those before surgery(P < 0.05); The Lund-Kennedy endoscopic sinus score and Lund-Mackay paranasal sinus CT score of patients 6 and 12 months after surgery were lower than those 3 months after surgery(P < 0.05); The Lund-Kennedy endoscopic sinus score and Lund-Mackay paranasal sinus CT score of patients 12 months after surgery were lower than those 6 months after surgery(P < 0.05). The nasal mucosal ciliary motor velocity of patients 6 and 12 months after surgery was lower than that before surgery(P < 0.05); The nasal mucosal ciliary motor velocity of patients 12 months after surgery was lower than that 6 months after surgery(P < 0.05). The Lund-Kennedy endoscopic sinus score was positively correlated with Lund-Mackay paranasal sinus CT score in patients before surgery, 3, 6 and 12 months after surgery(P < 0.05); The Lund-Kennedy endoscopic sinus score was negatively correlated with nasal mucosal ciliary motor velocity in patients before surgery, 6 and 12 months after surgery(P < 0.05); The Lund-Mackay paranasal sinus CT score was negatively correlated with nasal mucosal ciliary motor velocity in patients before surgery, 6 and 12 months after surgery(P < 0.05).Conclusion There is good correlation among the Lund-Kennedy endoscopic sinus score, the Lund-Mackay paranasal sinus CT score and the nasal mucosal ciliary motor velocity in patients with recurrent sinusitis before and after revision endoscopic sinus surgery. This study establishes an objective evaluation system for evaluating the changes in nasal function with these three indexes as the main body.
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Key words:
- sinusitis /
- revision endoscopic sinus surgery /
- nasal function
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表 1 手术前后Lund-Kennedy鼻内镜评分和Lund-Mackay鼻窦CT评分比较
时间 Lund-Kennedy鼻内镜评分 Lund-Mackay鼻窦CT评分 术前 11.67±3.34 13.28±4.15 术后3个月 9.18±2.721) 10.92±3.071) 术后6个月 7.89±2.051)2) 8.94±2.721)2) 术后12个月 5.53±2.261)2)3) 7.13±2.851)2)3) 与术前比较，1)P < 0.05;与术后3个月比较，2)P < 0.05;与术后6个月比较，3)P < 0.05。 
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