Shen Bin, Liu Li-Ting, Liu Dan, Guo Qi-Yun, Dong Pin
Department of Otolaryngology-Head & Neck Surgery, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai 200080, China.
Department of Otolaryngology, Weifang People's Hospital Weifang 261041, China.
Int J Clin Exp Med. 2014 Jun 15;7(6):1585-91. eCollection 2014.
Chronic rhinosinusitis (CRS) is not a life-threatening disorder but may have a great impact on the patients. This study intended to evaluate the impact of functional endoscopic sinus surgery (FESS), and compare the effect and quality of life (QOL) after two different surgical approaches on patients with CRS. Sixty patients of CRS were analyzed before and after FESS. The extent of disease was evaluated by the Lund-Mackay scoring system using computed tomography (CT) and endoscopy. Subjective patient QOL scores were assessed by SF-36 questionnaire and symptom scores were recorded using the SNOT-20 questionnaire. Forty patients of multiunit CRS were randomly allocated to two groups in order to be taken radical FESS (RFESS) and conservative FESS (CFESS), respectively. The Lund-Mackay score and degree of preoperative polyps did not differ statistically between the two groups. In the 1 months follow-up settings, such domains as role physical, mental health, role emotional and general health of SF-36, and total of the SNOT-20 items scores and the most important 5-item scores of SNOT-20 all began to get better markedly (P<0.05); in the 6-12 months follow-up settings, the indices of QOL and symptoms status entirely improved from the baseline, and CFESS scope surgery is no significantly difference with RFESS in improving the QOL and symptoms of patients. The results of this study suggesting that nasal polyps have a significant negative impact on the patients with CRS. FESS is a reliable and effective method for improving a patient's QOL and symptoms after 6 months of surgery, regardless of approaches.
慢性鼻-鼻窦炎（CRS）并非危及生命的疾病，但可能对患者产生重大影响。本研究旨在评估功能性鼻内镜鼻窦手术（FESS）的影响，并比较两种不同手术方式对CRS患者术后的效果和生活质量（QOL）。对60例CRS患者在FESS术前和术后进行分析。采用计算机断层扫描（CT）和鼻内镜检查，通过Lund-Mackay评分系统评估疾病范围。采用SF-36问卷评估患者主观QOL评分，使用SNOT-20问卷记录症状评分。将40例多鼻窦CRS患者随机分为两组，分别接受根治性FESS（RFESS）和保守性FESS（CFESS）。两组患者的Lund-Mackay评分和术前息肉程度在统计学上无差异。在1个月的随访中，SF-36的角色生理、心理健康、角色情感和总体健康等领域，以及SNOT-20项目总分和SNOT-20最重要的5项评分均开始显著改善（P<0.05）；在6-12个月的随访中，QOL和症状状态指标均从基线完全改善，CFESS范围手术在改善患者QOL和症状方面与RFESS无显著差异。本研究结果表明鼻息肉对CRS患者有显著负面影响。FESS是一种可靠且有效的方法，无论采用何种手术方式，术后6个月均可改善患者的QOL和症状。
