Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre.
Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre.
复制标题
现实生活研究表明，在第三级转诊中心，鼻窦手术后不受控制的鼻孔炎。
DOI：
10.1111/all.12983
复制
发表时间：
2017-02
期刊：
影响因子：
12.4
通讯作者：
Hellings PW
中科院分区：
文献类型：
--
作者：
van der Veen J;Seys SF;Timmermans M;Levie P;Jorissen M;Fokkens WJ;Hellings PW
欧洲鼻窦炎立场文件（EPOS）指南提供了评价慢性鼻窦炎（CRS）控制的综合标准，将患者症状的严重程度、鼻粘膜的外观和药物摄入作为CRS控制的参数。使用新的EPOS控制标准研究功能性内窥镜鼻窦手术（FESS）后3 - 5年的CRS控制程度，并将这些数据与症状评分相关联。纳入研究前3 - 5年因慢性炎症性鼻窦疾病接受双侧FESS的成人CRS患者（n = 560）。根据EPOS控制标准、总鼻窦症状和个体鼻窦症状的视觉模拟量表（VAS）评分、鼻窦结局测试（SNOT）-22和简明量表（SF）-36问卷，对患者进行邮寄问卷调查，要求提供对照项目。CRS控制良好者占19.5%，部分控制者占36.8%，未控制者占43.7%。对照水平对应于平均总VAS、SNOT-22和SF-36评分。亚组分析显示，女性性别、阿司匹林不耐受和FESS翻修与未控制CRS的患病率较高相关，而过敏、哮喘和吸烟状态并没有改变每个控制类别中患者的百分比。在81例门诊患者中，鼻内窥镜检查仅改变了4例患者（4.9%）的分类。根据新的EPOS控制标准，至少40%的CRS患者在FESS后3 - 5年未得到控制。因此，更好的治疗策略，导致更高的疾病控制是必要的CRS护理。
The European Position Paper on Sinusitis (EPOS) guidelines provide composite criteria to evaluate chronic rhinosinusitis (CRS) control, taking into consideration the severity of patients’ symptoms, aspect of nasal mucosa and medical intake as parameters of CRS control. To study the degree of CRS control using novel EPOS control criteria at 3–5 years after a functional endoscopic sinus surgery (FESS) and correlate these data to symptoms scores. Adult CRS patients (n = 560) who had undergone bilateral FESS for chronic inflammatory sinonasal disease 3–5 years prior to the study were included. Patients received a postal questionnaire asking for control items according to EPOS control criteria, visual analogue scale (VAS) scores for total and individual sinonasal symptoms, sinonasal outcome test (SNOT)‐22 and Short Form (SF)‐36 questionnaires. About 19.5% of CRS patients were well controlled, with 36.8% of patients being partly controlled and 43.7% uncontrolled. The levels of control corresponded to mean total VAS, SNOT‐22 and SF‐36 scores. Subgroup analysis revealed that female gender, aspirin intolerance and revision FESS were associated with higher prevalence of uncontrolled CRS, whereas allergy, asthma and smoking status did not alter the percentage of patients in each category of control. In 81 patients attending the outpatient clinic, nasal endoscopy changed classification in only four patients (4.9%). Based on the novel EPOS control criteria, at least 40% of CRS patients are uncontrolled at 3–5 years after FESS. Therefore, better treatment strategies leading to higher disease control are warranted in CRS care.