鼻中隔偏曲矫正术的主客观评估及相关性分析

目的　探讨鼻中隔偏曲患者行鼻中隔矫正术前、术后的主、客观评估及相关性，评价该手术治疗鼻中隔偏曲的作用。方法　以46例鼻中隔偏曲伴不同程度鼻塞的 患者为研究对象，分别于术前、术后6～8周进行评估，主观方面应用视觉模拟量表（visual analogue scale，VAS）评分，客观方面应用鼻声反射及鼻阻力计，记录双侧鼻腔最小横截面积（nasal minimal cross-sectional area，NMCA）、鼻腔容积（nasal cavity volume，NCV）及鼻阻力（nasal resistance，NR），应用配对t 检验对各主、客观指标及其之间有无相关性进行统计学分析。结果　术前、术后在VAS、NCV及NR中显示差异均具有统计学意义（P <0.05），在NMCA中显示差异无统计学意义（P >0.05）。VAS与NMCA，NCV，NR三者之间没有统计学意义上的相关性。结论　鼻中隔偏曲矫正术能有效改善鼻中隔偏曲患者鼻塞症状。鼻腔通气功能的客观检查可以直观并量化的说明手术前、后鼻气道阻力和鼻腔结构的变化，是一种很好的评价参数且不与患者的主观感受一致。

Subjective and objective assessment and correlation analysis of the treatment surgery of deviated nasal septum

OBJECTIVE To assess the effect of surgery for patients with nasal septum deviation with subjective and objective parameters. METHODS Forty six patients with nasal septum deviation were included in this study. All the patients were assessed preoperatively and 6 to 8 weeks postoperatively. Visual analogue scale（VAS） was used as the subjective assessment tool. Acoustic rhinometry and rhinomanometry were used as the objective tools. The nasal minimum cross-sectional area（NMCA）, nasal cavity volume（NCV） and nasal airway resistance（NR） were recorded. A paired t-test was applied to analyze the correlation between subjective and objective parameters. R ESU LTS T he preoper at ive a nd postoper at ive measurements of VAS, NCV and NR showed statistical differences（P〈 0.05）. NMCA didn＇t show any statistical differences between the preoperative and postoperative measurement（P 〉0.05）. VAS had no statistical correlation with NMCA, NCV and NR respectively. CONCLUSION The surgery for nasal septum is effective to improve the symptoms of nasal obstruction in patients with deviated nasal septum. The objective examination of the nasal ventilation function can directly and quantitatively describe the changes of nasal airflow resistance and nasal structure before and after the surgery, but not consistent with the patient＇s subjective feelings.