慢性鼻炎的诊断和治疗。

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Tanja Hildenbrand, Katrin Milger-Kneidinger, Ingo Baumann, Rainer Weber
{"title":"慢性鼻炎的诊断和治疗。","authors":"Tanja Hildenbrand, Katrin Milger-Kneidinger, Ingo Baumann, Rainer Weber","doi":"10.3238/arztebl.m2024.0167","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by local chronic inflammation of the mucous membranes of the nose and paranasal sinuses. It affects approximately 5% of the population.</p><p><strong>Methods: </strong>This review is based on relevant publications retrieved by a selective search of the literature, with particular attention to current national and international guidelines.</p><p><strong>Results: </strong>CRS is defined by, and diagnosed on the basis of, a combination of symptoms and objective findings of nasal endoscopy and imaging studies. It markedly impairs quality of life and gives rise to both direct and indirect health care costs. In 20-45% of cases, CRS is associated with comorbid bronchial asthma and a significantly elevated risk of further diseases (e.g., COPD, OR 1.73; depression, HR 1.50; obstructive sleep apnea, OR 1.91; carcinoma, OR 1.14-5.30). CRS is primarily treated medically with topical steroids (standardized mean difference of nasal symptoms, -0.63 (95% confidence interval [-0.89; -0.37]; standardized mean difference of quality of life as measured by SNOT -22, -5.46 [-8.08; -2.84]), as well as with nasal lavage and, as an option, systemic steroids (and antibiotics where appropriate). If appropriate medical treatment fails to bring about adequate and sustained improvement, endoscopic sinus surgery is indicated. This improves the individual symptoms, the overall symptom score, and patients' quality of life. Severe refractory CRS with nasal polyposis can be treated with biological agents.</p><p><strong>Conclusion: </strong>CRS calls for individually adapted medical and/or surgical treatment.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"643-653"},"PeriodicalIF":6.5000,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Diagnosis and Treatment of Chronic Rhinosinusitis.\",\"authors\":\"Tanja Hildenbrand, Katrin Milger-Kneidinger, Ingo Baumann, Rainer Weber\",\"doi\":\"10.3238/arztebl.m2024.0167\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by local chronic inflammation of the mucous membranes of the nose and paranasal sinuses. It affects approximately 5% of the population.</p><p><strong>Methods: </strong>This review is based on relevant publications retrieved by a selective search of the literature, with particular attention to current national and international guidelines.</p><p><strong>Results: </strong>CRS is defined by, and diagnosed on the basis of, a combination of symptoms and objective findings of nasal endoscopy and imaging studies. It markedly impairs quality of life and gives rise to both direct and indirect health care costs. In 20-45% of cases, CRS is associated with comorbid bronchial asthma and a significantly elevated risk of further diseases (e.g., COPD, OR 1.73; depression, HR 1.50; obstructive sleep apnea, OR 1.91; carcinoma, OR 1.14-5.30). CRS is primarily treated medically with topical steroids (standardized mean difference of nasal symptoms, -0.63 (95% confidence interval [-0.89; -0.37]; standardized mean difference of quality of life as measured by SNOT -22, -5.46 [-8.08; -2.84]), as well as with nasal lavage and, as an option, systemic steroids (and antibiotics where appropriate). If appropriate medical treatment fails to bring about adequate and sustained improvement, endoscopic sinus surgery is indicated. This improves the individual symptoms, the overall symptom score, and patients' quality of life. Severe refractory CRS with nasal polyposis can be treated with biological agents.</p><p><strong>Conclusion: </strong>CRS calls for individually adapted medical and/or surgical treatment.</p>\",\"PeriodicalId\":11258,\"journal\":{\"name\":\"Deutsches Arzteblatt international\",\"volume\":\" Forthcoming\",\"pages\":\"643-653\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2024-09-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Deutsches Arzteblatt international\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3238/arztebl.m2024.0167\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Deutsches Arzteblatt international","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3238/arztebl.m2024.0167","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

摘要

背景:慢性鼻窦炎(CRS)是一种以鼻腔和副鼻窦粘膜局部慢性炎症为特征的异质性疾病。约有 5%的人口受其影响:方法:本综述基于通过选择性文献检索获得的相关出版物,尤其关注当前的国家和国际指南:结果:CRS 是根据症状和鼻内窥镜检查及影像学检查的客观结果综合定义和诊断的。CRS 严重影响患者的生活质量,并产生直接和间接的医疗费用。在 20%-45% 的病例中,CRS 与合并支气管哮喘有关,且罹患其他疾病的风险显著升高(如慢性阻塞性肺病,OR 1.73;抑郁症,HR 1.50;阻塞性睡眠呼吸暂停,OR 1.91;癌症,OR 1.14-5.30)。CRS 主要采用局部类固醇药物治疗(鼻部症状的标准化平均差异为 -0.63(95% 置信区间 [-0.89;-0.37];以 SNOT -22 衡量的生活质量的标准化平均差异为 -5.46 [-8.08;-2.84]),以及鼻腔灌洗和全身性类固醇药物(适当时还可使用抗生素)。如果适当的药物治疗未能带来充分和持续的改善,则应进行鼻旁窦内窥镜手术。这可以改善个别症状、总体症状评分和患者的生活质量。严重的难治性CRS合并鼻息肉可采用生物制剂治疗:结论:CRS 需要因人而异的药物和/或手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Diagnosis and Treatment of Chronic Rhinosinusitis.

Background: Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by local chronic inflammation of the mucous membranes of the nose and paranasal sinuses. It affects approximately 5% of the population.

Methods: This review is based on relevant publications retrieved by a selective search of the literature, with particular attention to current national and international guidelines.

Results: CRS is defined by, and diagnosed on the basis of, a combination of symptoms and objective findings of nasal endoscopy and imaging studies. It markedly impairs quality of life and gives rise to both direct and indirect health care costs. In 20-45% of cases, CRS is associated with comorbid bronchial asthma and a significantly elevated risk of further diseases (e.g., COPD, OR 1.73; depression, HR 1.50; obstructive sleep apnea, OR 1.91; carcinoma, OR 1.14-5.30). CRS is primarily treated medically with topical steroids (standardized mean difference of nasal symptoms, -0.63 (95% confidence interval [-0.89; -0.37]; standardized mean difference of quality of life as measured by SNOT -22, -5.46 [-8.08; -2.84]), as well as with nasal lavage and, as an option, systemic steroids (and antibiotics where appropriate). If appropriate medical treatment fails to bring about adequate and sustained improvement, endoscopic sinus surgery is indicated. This improves the individual symptoms, the overall symptom score, and patients' quality of life. Severe refractory CRS with nasal polyposis can be treated with biological agents.

Conclusion: CRS calls for individually adapted medical and/or surgical treatment.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信