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鼻中隔成形术是否能提高患者的生活质量?

Does septoplasty enhance the quality of life in patients?

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, P.O. Box 220, 00029 Helsinki, HUS, Finland.

出版信息

Eur Arch Otorhinolaryngol. 2012 Dec;269(12):2497-503. doi: 10.1007/s00405-012-1931-9. Epub 2012 Jan 25.

Abstract

Evaluation of the severity of disease and the effectiveness of operative treatment is commonly done by registering pre- and postoperative symptoms. During the preceding decade, greater awareness has focused not only on the symptoms but also on patients' quality of life (QoL). The aim of the study was to determine the effect of septoplasty, as measured by generic and disease-specific QoL questionnaires. The generic 15D and disease-specific SNOT-22 questionnaires were given to patients before the operation and 6 months after the operation. Data analysis consisted originally of 188 septoplasty patients. One-hundred and twenty-six patients (67%) answered the SNOT-22 questions, and in the 15D, the response rate was 76%. In the post-operative SNOT-22, the need to blow the nose, sneezing, runny nose, nasal obstruction, loss of smell or taste, post-nasal discharge, facial pain/pressure, difficulty in falling asleep and waking up at night improved significantly. However in the 15D the mean QoL, i.e., general well-being, became significantly poorer. The QoL became increasingly poor especially in the older age groups and among the patients in which the improvement achieved in nasal symptoms postoperatively was minor. The more nasal symptoms the patients had pre- or postoperatively, the poorer the QoL was in general. Based on our results, critical evaluation of the symptoms and findings in the patients is essential in deciding whether surgery or other treatment should be given to individual patients having nasal blockage symptoms. Especially in patients with mild symptoms or among older patients, adequate medical treatment has to be tried before even considering surgery. The results also encourage the use of a systematic questionnaire to estimate the severity of symptoms in daily clinical practice.

摘要

疾病严重程度和手术治疗效果的评估通常通过记录术前和术后症状来进行。在过去的十年中,人们不仅更加关注症状,而且更加关注患者的生活质量(QoL)。本研究的目的是通过通用和特定疾病的 QoL 问卷来确定鼻中隔成形术的效果。在手术前和手术后 6 个月,患者接受了通用的 15D 和特定疾病的 SNOT-22 问卷。数据分析最初包括 188 例鼻中隔成形术患者。126 例患者(67%)回答了 SNOT-22 问题,而在 15D 中,应答率为 76%。在术后 SNOT-22 中,擤鼻涕、打喷嚏、流鼻涕、鼻塞、嗅觉或味觉丧失、后鼻滴注、面部疼痛/压力、入睡困难和夜间醒来等症状明显改善。然而,在 15D 中,平均 QoL,即总体幸福感,明显变差。QoL 变得越来越差,尤其是在年龄较大的年龄组和术后鼻腔症状改善较小的患者中。患者术前或术后的鼻腔症状越多,总体 QoL 越差。基于我们的结果,对患者的症状和发现进行批判性评估对于决定是否应给予个别有鼻塞症状的患者手术或其他治疗至关重要。特别是在有轻度症状的患者或老年患者中,在考虑手术之前,必须尝试适当的药物治疗。这些结果还鼓励在日常临床实践中使用系统问卷来评估症状的严重程度。

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