不同部位鼻中隔偏曲矫正术后鼻腔通气功能研究

摘要

Objective To analyze preoperative and postoperative variation of nasal airway resistance and its relevance to subjective scoring in patients with deviation of nasal septum in different parts in order to provide evaluation index for septoplasty. Methods Sixty - three patients were divided into anterior deviation group and posterior deviation group. The visual analog scale and nasal airway resistance were done at one month before and after operation in both groups. The data was analyzed by T - test and Spearman correlation analysis. Results ①The postoperative sub-jective scoring and nasal airway resistance for the stenosis side in both groups obviously declined than before. The postoperative subjective scoring and unilateral expiration value and total expiration value declined obviously in both groups and the differences were statistically significant,but sta-tistically differences in unilateral inspiration value and total inspiration value were only found in anterior group. ②For wide nasal cavity,there were no obvious differences between preoperative subjective scoring and nasal airway resistance and postoperative ones in both groups. ③There was obvi-ous linear correlation between the subjective scoring and nasal airway resistance in ipsilateral side in anterior deviation group( P ﹤ 0. 05),while no such linear correlation was found in posterior deviation group( P ﹥ 0. 05). Conclusion The subjective scoring and nasal airway resistance de-termination have certain value for evaluating the effect of septoplasty in patients with deviation of nasal septum,especially for patients with anterior deviation of nasal septum.%目的：分析不同部位鼻中隔偏曲患者矫正手术前后鼻阻力的变化与主观评分的相关性，为鼻中隔偏曲矫正手术提供评价指标。方法将63例鼻中隔偏曲患者分为前部偏曲与后部偏曲两组，对两组患者矫正术前、术后1个月进行视觉模拟量表（VAS）主观评分，用前鼻孔测压法测得鼻腔阻力（单侧吸气阻力、单侧呼气阻力、吸气总阻力、呼气总阻力），进行配对资料的 t 检验和 Spearman 相关性分析。结果①两组患者狭窄侧鼻腔术后主观评分和鼻阻力均较术前下降。其中主观评分、单侧呼气阻力、双侧鼻腔呼气总阻力较术前明显下降，差异具有统计学意义，但手术前后的单侧吸气阻力和双侧吸气总阻力仅鼻中隔前部偏曲组患者具有统计学差异。②两组患者宽敞侧鼻腔术后主观评分和鼻腔阻力参数较术前皆无明显差异。③鼻中隔前部偏曲组患者狭窄侧主观评分与同侧鼻阻力具有显著直线相关性（ P ﹤0.05），而后部偏曲组患者狭窄侧主观评分与同侧吸气阻力无显著相关性（ P ﹥0.05）。结论主观评分和鼻腔阻力测定对于评价不同部位的鼻中隔偏曲手术效果具有一定的价值，对于鼻中隔前部偏曲手术效果具有较准确的评价意义。