真菌性鼻-鼻窦炎内镜手术前后主客观评估的应用分析

目的：研究主观调查量表和客观评估在真菌性鼻‐鼻窦炎（FRS ）患者鼻内镜手术前后应用的有效作用及其转变规律。方法应用视觉模拟量表（VAS）、鼻腔鼻窦结局测量20条（SNOT‐20）、Lund‐Mackay鼻窦CT评分以及Lund‐Kennedy鼻内镜评分，对130例FRS患者术前，术后第3、6个月进行前瞻性随访调查与评估，并进行各量表之间的相关性分析。结果术前，术后第3、6个月VAS、SNOT‐20、Lund‐Mackay鼻窦CT评分以及Lund‐Kennedy鼻内镜评分之间有明显相关性（P＜0．05），但术前VAS与Lund‐Kennedy鼻内镜评分间却无相关性（P＞0．05）。经鼻内镜手术后，除SNOT‐20术后第3个月的评分与术前有相关性外（P＜0．05），术前各量表分别与术后第3、6个月比较差异无统计学意义（P＞0．05）。但术后第3、6个月SNOT‐20、VAS、Lund‐kennedy鼻内镜评分相互比较差异有统计学意义（P＜0．05）。结论对FRS患者而言，术前主观量表与客观量表相结合可较好地反应患者术前的疾病情况，有助于手术时机的选择；术后应用主观评价与客观评价相结合进行随访，能够较全面反应手术后患者的病情转归。

Application of subjective and objective assessment on fungal rhino sinusitis after endoscopic surgery

Objective Study the useful effect of the subjective and objective assessmentscale in fungal‐rhino‐sinusitis (FRS) patients before and after endoscopic sinus surgery ,and thier transition rules .Methods Visual analog scale (VAS) ,sino‐nasal out‐come measures 20 (SNOT‐20) ,Lund‐Mackay CT score and Lund‐Kennedy nasal endoscopy score were used to prospective evaluate 130 cases of FRS patients at the time of before endoscopic sinussurgery ,the 3rd month and the6thmonth after survey ,and correla‐tion analysiswas took between the various scales .Results At the time ofbeforesurgery ,the 3rd month and the 6th month after the endoscopic sinus surgery ,the VAS ,SNOT‐20 ,Lund‐Mackay sinus CT scores and Lund‐Kennedy endoscopic score were significantly correlated (P< 0 .05) ,but At the time ofbeforesurgery ,VAS and Lund‐Kennedy nasal endoscopy scorehas no correlation(P>0 .05) .Except for SNOT‐20 scores at the time of 3rd month had relationship with preoperative scores(P<0 .05) ,there were no sig‐nificant relation of each scales that preoperative scores compared with 3rd month of 6th mouth(P> 0 .05) .The difference ofSNOT‐20 ,VAS ,Lund‐Kennedy nasal endoscopy scorewas statistically significant compared to each other at the time of 3rd month and the 6th month after surgery (P<0 .05) .Conclusion Subjective combined with objective scale can be a better response for patients be‐fore surgery ,which may be helpful for the choosing of operation time;combination of postoperative subjective evaluation with objec‐tive evaluation and following‐up ,may be a more effect way for patient to kmow the outcome after surgery .