Chen Feng-hong, Xu Rui, Zuo Ke-jun, Guo Yu-biao, Li Zhi-ping, Shi Jian-bo
Otorhinolaryngology Hospital, First Affiliated Hospital of SUN Yat-sen University, Guangzhou 510080, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Jun;46(6):444-8.
To evaluate the efficacy of endoscopic sinus surgery (ESS)-based on multidisciplinary treatment for patients with chronic rhinosinusitis (CRS) and asthma.
The study included 25 CRS patients with asthma who received ESS from September 2006 to March 2009, besides surgery, who also used corticosteroid nasal spray, oral macrolide antibiotics and nasal irrigation perioperatively. Evaluation was performed before ESS, 1 year and 3 years post-ESS. Evaluation index included visual analogue scale (VAS) and endoscopy Lund-Kennedy assessment for CRS, and asthma control test (ACT) and pulmonary function tests for asthma.
Twenty-three (92%) patients were followed up for 12 months. Twelve (48%) of them were followed up for 36 months. CRS efficacy: VAS of general symptom significantly improved after ESS compared to pre-ESS (8.12 ± 0.60, x(-) ± s), after 1 year (3.20 ± 2.19) and 3 year (3.79 ± 2.32) follow up (both P = 0.000). There was no statistic difference between 1 year and 3 year follow up (P = 0.851). Endoscopy Lund-Kennedy score significantly improved in post-ESS after 1 year (4.35 ± 3.21) and 3 year (5.50 ± 2.64) follow up compared to pre-ESS (9.80 ± 2.10, both P = 0.000), and there was no difference between 1 year and 3 year follow up (P = 0.606). Asthma efficacy: ACT pre-ESS, 1 year and 3 year were 21.96 ± 2.16, 23.61 ± 1.94 and 22.33 ± 3.47, without statistic difference (F = 2.871, P = 0.065). Pulmonary function showed no significant change after surgery (Pre-ESS 74.68 ± 11.09, 1 year 73.27 ± 12.27, 3 year 73.50 ± 7.87, F = 0.076, P > 0.05).
ESS improves CRS with asthma significantly and persistently. Asthma control level, anti-asthma drug dose and pulmonary function remain stable after ESS.
评估基于多学科治疗的鼻内镜鼻窦手术（ESS）对慢性鼻-鼻窦炎（CRS）合并哮喘患者的疗效。
本研究纳入了25例2006年9月至2009年3月期间接受ESS治疗的CRS合并哮喘患者，除手术外，患者在围手术期还使用了糖皮质激素鼻喷雾剂、口服大环内酯类抗生素及鼻腔冲洗。在ESS术前、术后1年和3年进行评估。评估指标包括用于CRS的视觉模拟量表（VAS）和内镜Lund-Kennedy评估，以及用于哮喘的哮喘控制测试（ACT）和肺功能测试。
23例（92%）患者随访12个月，其中12例（48%）随访36个月。CRS疗效：与ESS术前相比，ESS术后一般症状的VAS显著改善（8.12±0.60，x(-)±s），术后1年（3.20±2.19）和3年（3.79±2.32）随访时均显著改善（P均=0.000）。1年和3年随访之间无统计学差异（P=0.851）。与ESS术前（9.80±2.10）相比，术后1年（4.35±3.21）和3年（5.50±2.64）随访时内镜Lund-Kennedy评分均显著改善（P均=0.000），1年和3年随访之间无差异（P=0.606）。哮喘疗效：ESS术前、1年和3年的ACT分别为21.96±2.16、23.61±1.94和22.33±3.47，无统计学差异（F=2.871，P=0.065）。术后肺功能无显著变化（ESS术前74.68±11.09，1年73.27±12.27，3年73.50±7.87，F=0.076，P>0.05）。
ESS能显著且持续地改善CRS合并哮喘患者的病情。ESS术后哮喘控制水平、抗哮喘药物剂量及肺功能保持稳定。
