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改良全球骨炎评分在慢性鼻-鼻窦炎中的临床应用

[Clinical application of modified global osteitis score in chronic rhinosinusitis].

作者信息

Li Y X, Lin F, Cheng L, Huang Q, Huang Z X, Zhang X Q, Zhou B

机构信息

Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Beijing, 100730, China.

Department of Otolaryngology, Children's Hospital Capital Institute of Pediatrics.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Nov 5;31(21):1666-1670. doi: 10.13201/j.issn.1001-1781.2017.21.011.

Abstract

To compare GOSS and a newly proposed modified scoring system for assessment of CRS with osteitis.Seventy-one CRS patients were enrolled prospectively.Their preoperative computed tomography (CT) were assessed for severity and extent of osteitis by two otolaryngologists using OsiriX DICOM Viewer software. The method of measurement was similar with GOSS, which retained scoring maxillary and sphenoid, producing a modified global osteitis score(rang: 0-20). Collected the history and completed VAS, SNOT-22, Lund-Kennedy, Lund-Mackay in preoperative. Postoperative follow-up mounted up to 12 months and evaluating CRS patients' outcome. Compared for test-retest and inter-rater reliability between the modified system and GOSS.There is a significant linear positive correlation between Modified GOSS score and GOSS(=0.913,<0.001).And Modified GOSS had more association with pre and postoperative L-M and L-K scores than GOSS (=0.316, 0.357). The modified GOSS showed the highest inter-rater and test-retest, interclass correlation coefficient (pre-ICC=0.947; post-ICC=0.943).Modified GOSS may be a more suitable and convenient scoring system for clinical practice to grading osteitis.

摘要

比较GOSS和一种新提出的改良评分系统对伴有骨炎的慢性鼻-鼻窦炎(CRS)的评估情况。前瞻性纳入71例CRS患者。两名耳鼻喉科医生使用OsiriX DICOM Viewer软件对他们术前的计算机断层扫描(CT)进行骨炎严重程度和范围的评估。测量方法与GOSS类似,保留对上颌窦和蝶窦的评分,得出改良的整体骨炎评分(范围:0 - 20)。术前收集病史并完成视觉模拟评分(VAS)、鼻窦症状测试-22项问卷(SNOT-22)、Lund-Kennedy评分、Lund-Mackay评分。术后随访长达12个月并评估CRS患者的结局。比较改良系统和GOSS之间的重测信度和评分者间信度。改良GOSS评分与GOSS之间存在显著的线性正相关(r = 0.913,P < 0.001)。并且改良GOSS与术前和术后的Lund-Mackay评分及Lund-Kennedy评分的相关性比GOSS更高(r分别为0.316、0.357)。改良GOSS显示出最高的评分者间、重测及组内相关系数(术前组内相关系数=0.947;术后组内相关系数=0.943)。改良GOSS可能是临床实践中用于骨炎分级的更合适、更便捷的评分系统。

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