鼻声反射在选择慢性鼻及鼻窦炎治疗策略中的价值

目的探讨鼻黏膜充血指数与慢性鼻及鼻窦炎(chronic rhinosinusitis,CRS)组织重构程度之间的相关性,为临床选择治疗方法提供客观依据。方法接受鼻内镜手术的CRS患者44例,应用鼻声反射仪进行测量来获取鼻黏膜充血指数;CRS患者钩突黏膜标本行鼻黏膜血管密度和纤维化程度评分;应用统计学方法对其相关性进行分析。结果鼻黏膜纤维化程度、血管密度与鼻黏膜充血指数之间有显著相关性,其中鼻黏膜充血指数与纤维化程度呈负相关(r=-0.522,P=0.00),与血管密度呈正相关(r=0.838,P=0.00)。黏膜下纤维化程度与血管密度结合与鼻声反射黏膜充血指数有显著相关性,决定系数(R~2)高达0.778。结论以鼻黏膜充血指数确定病变黏膜顺应性,进而确定药物治疗的敏感性及选择合适的手术适应证,指导治疗策略。

Value of acoustic rhinometry in guiding the treatment of chronic rhinosinusitis

OBJECTIVE To investigate the correlation between congestion index and tissue remodeling degree of nasal mucosa in patients with chronic rhinosinusitis(CRS)and to provide the evidence for therapeutic choice.METHODS Forty- four patients with CRS who underwent endoscopic surgery were studied.Congestion index of nasal mucosa was obtained by acoustic rhinometry and the mucosa specimen of uncinate process from the patient's nasal cavity was used to evaluate the vascular density and fibrosis degree.Statistical analysis was performed using SPSS.RESULTS Congestion index of nasal mucosa had a positive correlation with vascular density of mucosa(r=0.838, P=0.00),whereas it had a negative correlation with fibrosis degree of mucosa(r=-0.522,P=0.00).The determination coefficient was 0.778.CONCLUSION Using congestion index as an indication of nasal mucosa compliance provides a possible method for evaluating the sensibility of patient to drug therapy and may make us to choice the surgical management more rationally.