慢性鼻及鼻窦炎中筛骨病理学分析和CT的诊断价值

目的结合术中所见,探讨慢性鼻及鼻窦炎（CRS）患者筛骨病变特点及CT影像诊断价值。方法 44例CRS患者,男25例,女19例,年龄20～58岁,平均42.3岁。采用Biedlingmaier分级标准对筛骨病理改变进行分级,行Lund-Mackay评分。鼻内镜术后1年对患者行视觉模拟评分（visual analogue scale,VAS）和Lund-Kennedy内镜评分,分析其与筛骨病理改变的关系;用同样的统计学方法分析CT值与病变程度及筛骨病理改变的关系。结果根据筛骨病理改变程度,将CRS患者筛骨病理学改变分为I～IV级。术后1年VAS评分随骨质病理等级的增高而增高（r=0.914,P〈0.01）。术后1年Lund-Kennedy评分随骨质病理等级的增高而增高（r=0.871,P〈0.01）。筛骨病理的不同分级之间,其CT值有明显的差异性（P〈0.01）,Spearman相关性分析发现筛骨CT值与病变程度（Lund-Mackay评分）呈显著性相关（r=0.637,P〈0.01）,CT值与筛骨病理学改变呈显著性相关（r=0.839,P〈0.01）。结论 CRS中有一部分患者存在筛骨病变,这种病变包括筛骨黏膜增厚、骨吸收、骨破坏、炎性细胞的浸润以及新骨形成。筛骨病理等级越高,预后越差。CRS患者筛骨CT值与病变范围和筛骨病理分级显著相关,可客观评价CRS患者筛骨病变程度,为预后提供依据。

Pathological changes of the ethmoid bones in chronic rhinosinusitis and the clinical diagnostic value of CT

OBJECTIVE To explore the pathological changes of ethmoid bones and the diagnostic value of CT in chronic rhinosinusitis(CRS). METHODS There were 44 patients(19 women and 25 men)included in this study. Their ages ranged from 20 to 58 years,with an average age of 42.3 years. The Biedlingmaier criterion was used to determine the pathological grade of ethmoid bones,and the Lund-Mackay scores of the ethmoid bone were recorded. VAS scores and Lund-Kennedy scores were recorded one year after FESS and the correlati...