鼻内镜手术对成人慢性鼻-鼻窦炎伴哮喘患者疗效的影响

目的　分析并探讨鼻内镜手术对成人慢性鼻-鼻窦炎（chronic rhinosinusitis，CRS）伴哮喘患者疗效的影响。方法　采用前瞻性对照分组设计，对我院诊断为CRS并接受鼻内镜手术治疗的325例患者依入组标准选择92例患者进行跟踪随访，于术前、术后评估所有患者鼻部和哮喘各指标变化情况。结果　共92例完成3个月随访，90例完成12个月随访。鼻内镜手术后鼻部总体症状和鼻塞、流涕的视觉模拟量表评分以及鼻内镜Lund-Kennedy评分均明显改善，喷嚏、嗅功能、头面部疼痛视觉模拟量表评分结果也有不同程度改善。伴哮喘患者鼻内镜手术后哮喘控制测试评分在术后明显升高，而肺功能各指标变化无统计学差异。结论　以鼻内镜手术为中心的综合治疗对成人CRS伴哮喘患者的鼻部症状改善和减少用药量有显著作用；短期内鼻内镜手术对提高哮喘患者哮喘控制水平和减少哮喘用药量有积极作用。

Effect of endoscopic sinus surgery on adult patients with chronic rhinosinusitis and asthma

OBJECTIVE The purpose of this study is to analyze and investigate the effect of endoscopic sinus surgery on adult patients with chronic rhinosinusitis and asthma. METHODS This study is a prospective study of 92 adult patients with combined airway disease selected from 325 patients who had endoscopic sinus surgery since February 2010. All the 92 patients were followed up after surgery. The related indicators of nasal sinus and asthma were observed and analyzed. RESULTS 92 patients had completed follow-up of 3 months, 90 patients had completed follow-up of 12 months. After ESS, nasal symptoms, VAS score of nasal obstruction, rhinorrhea, and nasal endoscopic Lund-Kennedy score were significantly improved. VAS score of sneezing, olfactory function, head and facial pain also showed various improvement. Asthma Control Test（ACT） score of CRS patients with asthma increased significantly after ESS. The indexes of pulmonary function after ESS showed no significant difference compared with the baseline. CONCLUSION Endoscopic sinus surgery combined medicine therapy to improve the nasal symptoms and reduce the dosage on adult patients with CRS and asthma has a distinct role. Endoscopic sinus surgery has a positive effect to improve the level of asthma control and reduce the dosage on CRS patients with asthma in the short term.