Subjective and objective comparative analysis of nasal ventilation function before and after nasal septoplasty
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摘要: 目的 利用鼻阻塞症状(nasal obstruction symptom evaluation，NOSE)评分量表及鼻功能检查探讨患者行鼻中隔成形术前术后的鼻腔通气情况变化，探讨患者主观鼻塞与鼻功能检查之间的相关性及临床应用价值。方法 选取2021年12月至2023年4月的129例鼻中隔偏曲患者进行研究，所有患者均行鼻中隔成形术。对所有患者术前及术后3个月进行NOSE量表调查。应用鼻声反射、鼻阻力计及鼻呼吸量仪器，记录患者术前及术后双侧鼻腔最小横截面积(nasal minimal cross-sectional area，MCA)、鼻腔容积(nasal cavity volume，NCV)、鼻腔总阻力(nasal resistance，NR)、最小横截面积距前鼻孔的距离(the distance between the nostril to minimum cross-sectional area，MD)、鼻腔吸气量(nasal inspiratory volume，IV)、呼气量(nasal expiratory volume EV)、鼻呼吸气量差异比(the nasal partitioning ratio，NPR)包括吸气量差异比(NPRi)及呼气量差异比(NPRe)等客观指标。应用配对t检验比较分析各项指标术前、术后的变化，差异有统计学意义(P < 0.05)，以及利用Pearson相关直线分析主客观指标之间的相关性。结果 129例患者术前、术后的NOSE评分、NCV、NR、MD、EV、IV、NPRe、NPRi均显示差异有统计学意义(P < 0.05)，仅术前、术后的MCA差异无统计学意义(P>0.05)。术前NOSE评分与NR、NCV、EV、IV、NPRe、NPRi之间具有相关性(P < 0.05)，与MD、MCA之间不具有相关性(P>0.05)。术后NOSE评分与NR、MCA、NCV、EV、IV、NPRe、NPRi之间具有相关性(P < 0.05)，与MD之间不具有相关性(P>0.05)。结论 NOSE量表联合鼻功能检查对于评估鼻中隔偏曲患者手术疗效具有一定的临床参考价值。Abstract: Objective To investigate the changes of nasal ventilation before and after septoplasty by using NOSE scoring scale and nasal function examination, and to explore the correlation between subjective nasal obstruction and nasal function examination and its clinical application value.Methods A total of 129 cases of nasal septum deviation from December 2021 to April 2023 in our hospital were selected for study. All patients underwent septoplasty. Nasal obstruction symptom evaluation(NOSE) was performed in all patients before surgery and 3 months after surgery. nasal minimal cross-sectional area(MCA) and nasal cavity volume(NCV) were recorded by nasal acoustic reflex, nasal resistance meter and nasal respiration apparatus, nasal resistance(NR), distance between the nostril to minimum cross-sectional area, (the distance between the nostril to minimum cross-sectional area, MD), nasal inspiratory volume(IV), nasal expiratory volume(EV), the nasal partitioning ratio, NPR includes objective indicators such as inspiratory volume difference ratio(NPRi) and expiratory volume difference ratio(NPRe). Paired test was used to compare and analyze the changes of various indicators before and after surgery, and the difference(P < 0.05) was statistically significant, and Pearson correlation linear analysis was used to analyze the correlation between subjective and objective indicators.Results There were statistically significant differences in NOSE score, NCV, NR, MD, EV, IV, NPRe and NPRi of 129 patients before and after surgery(P < 0.05), while there was no statistically significant difference between MCA before and after surgery(P>0.05). Preoperative NOSE score was correlated with NR, NCV, EV, IV, NPRe and NPRi(P < 0.05), but not with MD and MCA(P>0.05). There was correlation between NOSE score and NR, MCA, NCV, EV, IV, NPRe and NPRi(P < 0.05), but no correlation between nose score and MD(P>0.05).Conclusion The subjective NOSE scale combined with nasal function test has certain clinical reference value in evaluating the surgical effect of patients with deviated nasal septum.
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表 1 手术前后主观评分及鼻功能指标比较
X±S 指标 术前 术后 t P NOSE评分 54.57±28.91 17.67±12.02 15.13 < 0.05 NR/Pa·cm-3·s-1 1.33±0.62 0.48±0.13 14.73 < 0.05 MCA/cm2 0.41±1.66 0.57±0.18 -1.13 0.26 MD/cm 2.61±0.81 2.33±0.74 3.57 < 0.05 NCV/cm3 5.37±1.73 10.20±1.97 -22.75 < 0.05 EV/L 1.23±0.78 2.46±0.79 -14.51 < 0.05 IV/L 1.13±0.71 2.32±0.79 -14.51 < 0.05 NPRe/Pa·cm-3·s-1 0.90±4.19 0.14±0.32 2.05 < 0.05 NPRi/Pa·cm-3·s-1 0.53±0.26 0.15±0.30 11.37 < 0.05 
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表 2 术前NOSE评分与各指标相关性分析
指标 相关系数 P NR 0.785 < 0.050 MCA -0.113 0.202 MD 0.136 0.125 NCV -0.586 < 0.050 EV -0.522 < 0.050 IV -0.521 < 0.050 NPRe 0.675 < 0.050 NPRi 0.768 < 0.050
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表 3 术后NOSE评分与各指标相关性分析
指标 相关系数 P NR 0.353 < 0.050 MCA -0.239 < 0.050 MD 0.037 0.675 NCV -0.195 < 0.050 EV -0.347 < 0.050 IV -0.423 < 0.050 NPRe 0.310 < 0.050 NPRi 0.350 < 0.050
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