本文選題：慢性鼻-鼻竇炎 + 骨炎�。� 參考：《臨床耳鼻咽喉頭頸外科雜志》2017年21期

【摘要】：目的:探討改良整體骨炎評分(GOSS)在慢性鼻-鼻竇炎中的臨床應(yīng)用價值。方法:前瞻性研究,連續(xù)納入藥物治療無效準(zhǔn)備行鼻內(nèi)鏡手術(shù)的71例慢性鼻-鼻竇炎患者,通過OsiriX軟件測量鼻竇CT,根據(jù)雙側(cè)額竇、篩竇、蝶竇、上頜竇骨炎的范圍及厚度行GOSS評分及改良GOSS評分(同法,只測量雙側(cè)蝶竇及上頜竇),并于術(shù)前行視覺模擬量表(VAS)、鼻腔鼻竇結(jié)局測試-22(SNOT-22)、Lund-Kennedy(L-K)、Lund-Mackay(L-M)評分,術(shù)后1年進行療效評判,再次行VAS、SNOT-22、L-K、L-M評分。應(yīng)用SPSS 23.0軟件分析改良GOSS評分的臨床價值。結(jié)果:(1)改良GOSS評分與GOSS之間存在顯著線性正相關(guān)(r=0.913,P0.001);(2)改良GOSS評分及GOSS評分與術(shù)前及術(shù)后L-K評分、L-M評分間存在相關(guān)性,改良GOSS評分與其相關(guān)性更高(r=0.316、0.357);與主觀VAS評分、SNOT-22評分之間相關(guān)性差異無統(tǒng)計學(xué)意義(P0.05);(3)檢驗不同評分者間GOSS評分與改良GOSS評分的差異,GOSS評分組內(nèi)相關(guān)系數(shù)為0.933(95%CI 0.893~0.958),改良GOSS評分組內(nèi)相關(guān)系數(shù)為0.947(95%CI0.916~0.967),改良GOSS評分較GOSS評分其信度及一致性更好。結(jié)論:改良GOSS評分能夠更客觀準(zhǔn)確地反映慢性鼻-鼻竇炎患者骨炎程度,簡化測量,信度及一致性良好,便于臨床應(yīng)用。
[Abstract]:Objective: to evaluate the clinical value of modified global osteositis score (GOSS) in chronic rhinosinusitis. Methods: in a prospective study, 71 patients with chronic rhinosinusitis were enrolled in the study. The CTs were measured by OsiriX software, according to bilateral frontal sinus, ethmoid sinus, sphenoid sinus, bilateral frontal sinus, ethmoid sinus and sphenoid sinus. The range and thickness of maxillary sinus osteositis were evaluated with GOSS score and modified GOSS score (same method, bilateral sphenoid sinus and maxillary sinus were measured, visual analogue scale was performed before operation, nasal sinus outcome test -22 SNOT-22 Lund-Kenneth L-Knn Lund-MackayL-Mm), and the curative effect was evaluated one year after operation. VASN SNOT-22 and L-KN-M scores were performed again. The clinical value of modified GOSS score was analyzed by SPSS 23. 0 software. Results there was a significant linear positive correlation between the modified GOSS score and the GOSS score. There was a significant correlation between the modified GOSS score and the GOSS score and the L-K score before and after the operation. The correlation between modified GOSS score and GOSS score was higher than that of SNOT-22 score. There was no significant difference between modified GOSS score and SNOT-22 score.) the difference of GOSS score and modified GOSS score between the two groups was significant (P < 0.05). The correlation coefficient of GOSS score and modified GOSS score was 0.8930.58in the group with improved GOSS score and modified SNOT-22 score, and there was no significant difference in the correlation between the modified score and the SNOT-22 score (P < 0.05). The correlation coefficient of GOSS score group was 0.947 ~ 95% CI 0.916 ~ 0.967m. The reliability and consistency of modified GOSS score was better than that of GOSS score. Conclusion: the modified GOSS score can more objectively and accurately reflect the degree of osteitis in patients with chronic rhinosinusitis, simplify the measurement, have good reliability and consistency, and be convenient for clinical application.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院耳鼻咽喉頭頸外科耳鼻咽喉頭頸外科教育部重點實驗室;首都醫(yī)科大學(xué)研究所附屬兒童醫(yī)院耳鼻咽喉科;首都醫(yī)科大學(xué)大興醫(yī)院耳鼻咽喉科;
【基金】：北京市醫(yī)院管理局“登峰”人才培養(yǎng)計劃(No:DFL20150202) 北京市教育委員會科技計劃重點項目(No:KZ201410025029) 院內(nèi)科研種子基金(No:2016-YJJ-ZZL-017)聯(lián)合資助
【分類號】：R765

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