目的 探讨鼻声反射、鼻阻力、鼻呼吸量检测对于鼻中隔偏曲(asal septal deviation,NSD)患者鼻塞严重程度的评估作用.方法 对102例NSD伴不同程度鼻塞的患者进行评估,主观方面应用视觉模拟量表(visual analogue scale,VAS)评分,根据VAS评分情况,把患者鼻塞严重程度分成轻度(VAS评分为0～3分)、中度(VAS评分＞3分且≤7分)、重度(VAS评分＞7分且≤10分)3组,应用鼻声反射、鼻阻力计及鼻呼吸量仪器,记录患者偏曲侧鼻腔的最小横截面积(minimal cross-sectional area,MCA)、鼻腔容积(nasal cavity volume,NCV)、鼻腔阻力(nasal resistance,NR)、最小横截面积距前鼻孔的距离(distance between the nostril to minimum cross-sectional area,MD)、鼻腔吸气量(inspiratory volume,IV)、鼻腔呼气量(expiratory volume,EV)、鼻呼吸气量差异比(nasal partitioning ratio,NPR)包括吸气量差异比(NPRi)及呼气量差异比(NPRe)等客观指标.应用单因素方差分析对3组不同鼻塞程度的患者进行比较,采用配对样本t检验对双侧鼻腔进行比较,并对各指标的相关性进行统计学分析.结果 偏曲侧鼻腔在MCA和NCV指标方面,轻度和中度、轻度和重度之间比较,差异有统计学意义(P＜0.01),但中度和重度此两项指标比较,差异无统计学意义(P＞0.05);在MD指标方面,3组间差异均无统计学意义(P＞0.05);在IV、EV、NPRi、NPRe指标方面,轻度和中度,轻度和重度之间比较差异有统计学意义(P＜0.01),但中度和重度此两项指标比较,差异无统计学意义(P＞0.05);在NR指标方面,3组间比较差异均无统计学意义(P＜0.01).对比双侧鼻腔发现,在NCV、MD、NR、IV、EV指标方面,同一患者两侧鼻腔之间比较,差异均有统计学意义(P＜0.05),而MCA指标比较,差异无统计学意义(P＞0.05).经相关性分析,NR与MCA、NCV0-7、IV、EV 等指标呈负相关(r 分别为-0.535、-0.651、-0.563、-0.524,P＜0.01),NR 与 NPRi、NPRe 均呈正相关(r分别为0.643、0.606,P＜0.01).结论 联合使用鼻声反射、鼻阻力及鼻呼吸量检测来评估鼻中隔偏曲患者的鼻塞严重程度较为全面.
Value of Nasal Function Tests in Assessing the Severity of Nasal Obstruction in Patients with Nasal Septal Deviation
Objective To investigate the role of nasal acoustic reflex,nasal resistance,and nasal respiratory volume in assessing the severity of nasal obstruction in patients with nasal septal deviation(NSD).Methods A total of 102 patients with NSD with different de-grees of nasal obstruction were evaluated by applying the visual analogue scale(VAS)scores.According to the VAS score,the severity of nasal obstruction was divided into three groups:mild(VAS score 0-3),moderate(VAS score＞3 and ≤7)and severe(VAS score＞7 and ≤10).The nasal minimal cross-sectional area(MCA),nasal cavity volume(NCV),nasal resistance(NR),the distance be-tween the nostril to minimum cross-sectional area(MD),nasal inspiratory volume(IV),nasal expiratory volume(EV),and the nasal partitioning ratio(NPR),including the inspiratory volume difference ratio(NPRi)and the expiratory volume difference ratio(NPRe)were recorded.The One-Way ANOVA was used to compare three groups of patients with different degrees of nasal obstruction,and paired-sample t-test was used to compare bilateral nasal passages,and the correlation of each index was statistically analyzed.Results For the deviated lateral nasal passages,in terms of MCA and NCV,there were significant differences between mild and moderate,mild and severe(P＜0.01),but there were no significant differences between moderate and severe(P＞0.05);there were no significant differences between the three groups(P＞0.05)in MD.On the four indicators of IV,EV,NPRi and NPRe,there were significant differ-ences between mild and moderate,mild and severe(P＜0.01),but there was no significant difference between moderate and severe both in these two indicators and on the NR indicator,there was a significant difference between all three(P＜0.01).There were significant differences in NCV,MD,NR,IV,EV between the bilateral nasal passages of the same patient(P＜0.05),but the difference in MCA was not obvious(P＞0.05).Correlation analysis showed that NR was negatively correlated with MCA,NCV0-7,IV and EV(r were-0.535,-0.651,-0.563,-0.524,P＜0.01),and NR was positively correlated with NPRi and NPRe(r were 0.643,0.606,P＜0.01).Conclusion The combination of nasal acoustic reflex,nasal resistance and nasal respiratory volume testing to assess the se-verity of nasal obstruction in patients with nasal septal deviation is more comprehensive.
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