目的:探讨慢性鼻-鼻窦炎(CRS)患者主观症状与客观检查的相关性。方法:采用视觉类比法(VAS)对75例CRS患者的全身不适感以及鼻塞、头昏或头痛、面部疼痛或胀满感、嗅觉障碍、鼻分泌物或后鼻漏5个单个症状进行评分;对鼻窦CT和鼻内镜检查这两项客观检查结果分别采用Lund-Mackay法和Lanza—Kennedy法进行评分;分析上述指标间的相关性。结果:①Lund—Mackay CT评分和Lanza—Kennedy鼻内镜检查评分正相关(r=0.88,P〈0.01);②嗅觉障碍VAS评分与Lund—Mackay CT评分和Lanza—Kennedy鼻内镜检查评分正相关(r值分别为0.57和0.53,均P〈0.01);鼻塞、头昏或头痛、面部疼痛或胀满、鼻分泌物或后鼻漏以及患者全身不适感症状VAS评分与Lund—Mackay CT评分和Lanza—Kennedy鼻内镜检查评分无显著相关性(均P〉0.05);5个单个症状VAS评分之和与Lund-Mackay CT评分正相关(r=0.26,P〈0.05),但与Lanza—Kennedy鼻内镜检查评分不相关(P〉0.05)。结论:CRS患者的主观症状同客观检查间无显著相关性,对CRS患者进行病情评估和治疗方式选择时必须结合主观症状和客观检查。
Objective:To explore the relationship between rhinosinusitis symptoms and objective sinus examinations. Method:Prospective data of 75 patients with CRS scheduled for surgery were collected and analyzed retrospectively. The preoperative computed tomography (CT) scans were graded according to Lund and Mackay. The preoperative nasal endoscopy was graded by assigning an endoscopy score according to Lanza and Kennedy. A visual analog scale (VAS) symptom score was completed. Result:①There was a significant correlation between preoperative CT and endoscpoy scores ( r =0.88, P〈0.01 ) ;② The severity of smell function disturbance correlated with severity of disease on CT scan and endoscopy ( r value was 0.57 and 0.53 respectively, P 〈0.01 ). However, other symptoms and overall sinonasal symptom severity had no correlation ( P 〉0.05). Furthermore, a statistically significant but weak correlation was found between the VAS score based on the sum of five sinonasal symptoms and the Lund-Mackay CT scan score( r =0.26, P 〈0.05), while no correlation between VAS score based on the sum of five sinonasal symptoms and endoscopy score was found ( P 〉0.05). Conclusion:There is no good correlation between CRS symptoms and objective examinations. In order to evaluate CRS patients' severity and select treatment properly, both symptoms and objective examinations must be considered.