本文選題：鼻竇炎 + 生活質(zhì)量　； 參考：《山東大學(xué)》2013年碩士論文

【摘要】：[研究背景和目的] 慢性鼻-鼻竇炎(Chronic fungal rhino-sinusitis, CRS)是耳鼻喉科最常見(jiàn)的慢性疾病之一,患有慢性鼻-鼻竇炎的患者很難被完全治愈,其對(duì)社會(huì)心理的影響也很難定量,使患者的身體、心理、社會(huì)功能受到極大影響,越來(lái)越受到耳鼻喉科醫(yī)師的重視。但是目前關(guān)于耳鼻喉科臨床醫(yī)生主觀評(píng)與CRS病情嚴(yán)重程度相關(guān)性分析的研究較少,本文主要從臨床醫(yī)生及患者的角度,分別比較他們的視覺(jué)模擬量表(visual analogue scale)VAS評(píng)分與計(jì)算機(jī)CT掃描、鼻內(nèi)鏡檢查以及鼻腔鼻竇結(jié)局測(cè)量20條(sino-nasal outcome test-20, SNOT-20)之間的是否存在相關(guān)性,進(jìn)一步了解哪個(gè)因素更能反映CRS病情的嚴(yán)重程度。 [研究方法] 本研究采用漢化SNOT-20、VAS評(píng)分、Lund—Kennedy鼻內(nèi)鏡評(píng)分系統(tǒng)以及Lund-Mackay CT評(píng)分系統(tǒng)前瞻性對(duì)110例慢性鼻-鼻竇炎患者進(jìn)行研究。由三位耳鼻喉臨床醫(yī)生根據(jù)患者的臨床資料分別對(duì)CRS病情嚴(yán)重程度進(jìn)行VAS主觀評(píng)分,并與患者的主觀評(píng)估、客觀檢查結(jié)果進(jìn)行相關(guān)性比較。同時(shí)將全部患者分為真菌性鼻竇炎組(fungal rhino-sinusitis, FRS)、CRS伴有鼻息肉(CRS with nasal polyps, CRSwNP)以及CRS不伴有鼻息肉(CRS without nasal polyps, CRSnNP)三個(gè)亞組后進(jìn)行臨床醫(yī)生VAS評(píng)分與患者的主觀評(píng)估、客觀檢查進(jìn)行相關(guān)性分析。 [結(jié)果] 三位臨床醫(yī)生對(duì)慢性鼻-鼻竇患者術(shù)前生活質(zhì)量的VAS均呈正相關(guān)(r=0.7105P＜0.0001, r=0.5644P＜0.0001, r=0.5204P＜0.0001)；在未分組的情況下,三位臨床醫(yī)生VAS評(píng)分平均數(shù)和Lund—Kennedy鼻內(nèi)鏡檢查評(píng)分呈正相關(guān)(r=0.6103,P＜0.0001),三位臨床醫(yī)生VAS評(píng)分平均數(shù)與Lund—Mackay CT評(píng)分呈正相關(guān)(r=0.7252,P＜0.0001)；真菌性鼻-鼻竇炎亞組中,三位臨床醫(yī)生VAS評(píng)分平均數(shù)與Lund—Kennedy鼻內(nèi)鏡檢查評(píng)分呈正相關(guān)(r=0.6056,P=0.01),與Lund—Mackay CT評(píng)分呈正相關(guān)(r=0.7199,P＜0.0011)；慢性鼻竇炎不伴鼻息肉亞組中,三位臨床醫(yī)生VAS評(píng)分平均數(shù)與Lund—Kennedy鼻內(nèi)鏡檢查評(píng)分呈正相關(guān)(r=0.6135,P=0.0003),與Lund—MackayCT評(píng)分呈正相關(guān)(r=0.4624,P＜0.0101)；慢性鼻竇炎伴有鼻息肉組亞中,三位臨床醫(yī)生VAS評(píng)分平均數(shù)與Lund—Kennedy鼻內(nèi)鏡檢查評(píng)分呈正相關(guān)(r=0.4419,P=0.0003),與Lund—Mackay CT評(píng)分呈正相關(guān)(r=0.7625,P＜0.0001)；無(wú)論是在分組前還是分組后,三位臨床醫(yī)生VAS評(píng)分平均數(shù)與SNOT-20評(píng)分和VAS評(píng)分均呈無(wú)相關(guān)(P＞0.05)；Lund—Kennedy鼻內(nèi)鏡檢查評(píng)分以及Lund—MackayCT評(píng)分在三個(gè)亞組之間存在顯著差異(P＜0.001),SNOT-20評(píng)分和VAS評(píng)分均無(wú)統(tǒng)計(jì)學(xué)差異(P＞0.05)。 [結(jié)論] 臨床醫(yī)生VAS評(píng)分能夠反映CRS病情嚴(yán)重程度,沒(méi)有發(fā)現(xiàn)與患者的生活質(zhì)量之間的相關(guān)性�；颊遃AS評(píng)分主要與患者生活質(zhì)量相關(guān),在一定程度也能反映病變嚴(yán)重程度。真菌性鼻-鼻竇炎、慢性鼻竇炎伴有鼻息肉,慢性鼻竇炎不伴鼻息肉亞組在鼻內(nèi)鏡檢查、CT評(píng)分以及醫(yī)生評(píng)分之間存在顯著差異,慢性鼻竇炎伴有鼻息肉得分較高。
[Abstract]:[background and objective] chronic rhino-sinusitis (CRSs) is one of the most common chronic diseases in the department of otolaryngology. Patients with chronic rhinosinusitis can hardly be completely cured and their psychosocial effects are difficult to quantify. Patients' physical, psychological and social functions are greatly affected, and more attention is paid by otolaryngologists. However, there are few studies on the correlation between the subjective evaluation of clinicians in otolaryngology and the severity of CRS. To compare the correlation between visual analogue scaleanalogue score and CT scan, nasal endoscopy and nasal sino-nasal outcome test-20 (SNOT-20) in their visual analogue scale. Better understand which factors reflect the severity of CRS. [methods] in this study, 110 patients with chronic rhinosinusitis were studied prospectively by Chinese SNOT-20 VAS and Lund-Kennedy nasal endoscopic scoring system and Lund-Mackay CT scoring system. According to the clinical data of the patients, three otolaryngology clinicians evaluated the severity of CRS by VAS subjective score, and compared with the subjective evaluation and objective examination results. At the same time, all the patients were divided into three subgroups: fungal rhino-sinusitis, FRSS-CRS with nasal polyposis (CRS with nasal polyps, SwNPN) and CRS without nasal polyps, CRSnNPs without nasal polyps (CRS without nasal polyps, CRSnNPN), and then the clinicians' VAS scores and subjective evaluation of the patients were evaluated. Objective examination was carried out for correlation analysis. [results] the VAS of the three clinicians were positively correlated with the quality of life (QOL) of chronic naso-paranasal sinus patients (P < 0.0001, P < 0.0001, r = 0.5644P < 0.0001, r = 0.5204P < 0.0001). The mean VAS score of three clinicians was positively correlated with Lund-Kennedy nasal endoscopy score (P < 0.0001), and the mean VAS score of three clinicians was positively correlated with Lund-Mackay CT score (P < 0.0001), while in the fungal rhinosinusitis subgroup, there was a positive correlation between the mean VAS score and Lund-Mackay CT score (P < 0.0001). The mean VAS score of three clinicians was positively correlated with Lund-Kennedy nasal endoscopy score and Lund-Mackay CT score was 0.6056, P < 0.00111.In the patients with chronic sinusitis without nasal polyps, there was a positive correlation between VAS score and Lund-Mackay CT score. The mean VAS score of three clinicians was positively correlated with Lund-Kennedy nasal endoscopy score, and was positively correlated with Lund-MackayCT score and Lund-MackayCT score (P < 0.0101). The mean VAS score of three clinicians was positively correlated with Lund-Kennedy nasal endoscopy score 0.0003 and Lund-Mackay CT score 0.7625 (P < 0.0001). There was no correlation between the average VAS score and SNOT-20 score and VAS score among the three clinicians (P > 0.05). There was no significant difference in Lund-Kennedy nasal endoscopy and Lund-MackayCT scores among the three subgroups (P < 0.001). There was no significant difference in SNOT-20 score and VAS score between the three subgroups (P > 0.05). [conclusion] the VAS score of clinicians can reflect the severity of CRS, and there is no correlation between VAS and quality of life. The VAS score is mainly related to the quality of life of the patients, and to some extent can also reflect the severity of the disease. Fungal rhinosinusitis, chronic sinusitis with nasal polyps, chronic sinusitis without nasal polyp subgroup had significant difference in nasal endoscopy CT score and doctor's score, chronic sinusitis with nasal polyp score was higher.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R765.21

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相關(guān)期刊論文 前2條

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本文編號(hào)：2047320