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[鼻中隔偏曲患者的精神病理学特征:初步分析]

[Psychopathological characteristics in patients with deviation of nasal septum: a preliminary analysis].

作者信息

Li W T, Chen X Z, Tu W J, Huang Z Z, Chang L H, Wang J, Zhang G H

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yatsen University, Guangzhou 510630, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Sep 7;51(9):655-660. doi: 10.3760/cma.j.issn.1673-0860.2016.09.004.

Abstract

To investigate the psychopathological characteristics in patients with deviation of nasal septum. Between May 2015 and December 2015, fourty-four patients with deviated nasal septum and 37 patients with vocal cord polyp as control were included in this study. Psychological characteristics were evaluated by a series of questionnaire instruments including symptom checklist-90 (SCL-90), self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Visual analogue scale (VAS) and rhinomanometry through front nostril were used to evaluate nasal symptom. The correlation between psychological characteristics and nasal symptom was evaluated. SPSS 20.0 software was used to analyze the data. The SCL-90 score in nasal septal deviation group was 130.4±48.3. The total score and total average score of SCL-90 had no significant difference between nasal septal deviation group and the Chinese standard or control group( value was 0.469, 0.112, 1.575, 1.564, respectively, all >0.05). The scores of somatization, depression and anxiety factors in nasal septal deviation group were higher than control group ( value was 2.380, 2.133, 1.969, respectively, all <0.05). The proportion of positive patients in these three factors between nasal septal deviation group and control group had significant differences (χ value was 11.585, 9.610, 5.429, respectively, all <0.05). The scores of SDS and SAS in nasal septal deviation group were 46.0±10.6 and 43.0±10.2, which were higher than that in the Chinese standard and control group ( value was 5.342, 6.236, 1.476, 3.013, respectively, all <0.05). There were 9 patients companying with depression or anxiety (20.5%, 20.5%, respectively) and 5 patients companying with depression and anxiety in nasal septal deviation group (11.4%). There were positive correlation not only between the scores of SDS and the depression factor of SCL-90 but also between the scores of SAS and the anxiety factor of SCL-90 (=0.415, =0.005, =0.445, =0.002, respectively). The scores of SDS and SAS had positive correlation (=0.392, =0.008). The VAS score of nasal obstruction was 6.0±3.2. The rhinomanometry in inspiratory and expiratory phase were (0.202±0.140) kPa·S/cm and (0.230±0.161) kPa·S/cm. Besides the positive correlation between the rhinomanometry in inspiratory phase and SDS (=0.332, =0.045), the psychological scores, including SCL-90 score, depression, anxiety factors score, SAS and SDS, had no correlation with VAS scores and rhinomanometry ( value was -0.030, -0.052, -0.026, 0.107, 0.185, 0.066, 0.160, 0.203, respectively, all >0.05). High prevalence of depression and anxiety is found in patients with deviation of nasal septum. The SCL-90 score is consistent with SDS and SAS. Besides the positive correlation between the rhinomanometry in inspiratory phase and SDS, the psychological scores (SCL-90 score, depression, anxiety factors score, SAS and SDS) have no correlation with VAS score and rhinomanometry.

摘要

探讨鼻中隔偏曲患者的心理病理特征。2015年5月至2015年12月,本研究纳入44例鼻中隔偏曲患者和37例声带息肉患者作为对照。采用症状自评量表90(SCL - 90)、自评抑郁量表(SDS)和自评焦虑量表(SAS)等一系列问卷工具评估心理特征。采用视觉模拟量表(VAS)和前鼻孔鼻阻力测量法评估鼻部症状。评估心理特征与鼻部症状之间的相关性。使用SPSS 20.0软件进行数据分析。鼻中隔偏曲组SCL - 90评分为130.4±48.3。鼻中隔偏曲组与中国常模或对照组相比,SCL - 90总分及总均分差异均无统计学意义(值分别为0.469、0.112、1.575、1.564,均>0.05)。鼻中隔偏曲组的躯体化、抑郁和焦虑因子得分高于对照组(值分别为2.380、2.133、1.969,均<0.05)。鼻中隔偏曲组与对照组这三个因子的阳性患者比例差异有统计学意义(χ值分别为11.585、9.610、5.429,均<0.05)。鼻中隔偏曲组SDS和SAS评分分别为46.0±10.6和43.0±10.2,高于中国常模和对照组(值分别为5.342、6.236、1.476、3.013,均<0.05)。鼻中隔偏曲组有9例伴有抑郁或焦虑(分别为20.5%、20.5%),5例伴有抑郁和焦虑(11.4%)。SDS评分与SCL - 90抑郁因子评分之间、SAS评分与SCL - 90焦虑因子评分之间均呈正相关(分别为=0.415,=0.005,=0.445,=0.002)。SDS和SAS评分呈正相关(=0.392,=0.008)。鼻塞的VAS评分为6.0±3.2。吸气相和呼气相鼻阻力测量值分别为(0.202±0.140)kPa·S/cm和(0.230±0.161)kPa·S/cm。除吸气相鼻阻力测量值与SDS呈正相关(=0.332,=0.045)外,包括SCL - 90评分、抑郁、焦虑因子评分、SAS和SDS在内的心理评分与VAS评分及鼻阻力测量值均无相关性(值分别为 - 0.030、 - 0.052、 - 0.026、0.107、0.185、0.066、0.160、0.203,均>0.05)。鼻中隔偏曲患者抑郁和焦虑的患病率较高。SCL - 90评分与SDS和SAS一致。除吸气相鼻阻力测量值与SDS呈正相关外,心理评分(SCL - 90评分、抑郁、焦虑因子评分、SAS和SDS)与VAS评分及鼻阻力测量值均无相关性。

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