影响霉菌性鼻窦炎鼻内镜手术疗效的原因探讨(1)
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[摘要] 目的:探讨影响霉菌性鼻窦炎鼻内镜手术疗效的原因。方法:通过随访120例霉菌性鼻窦炎鼻内镜手术患者,寻找影响疗效的原因。结果:经过6～36个月随访,治愈97例,占80.83%;复发23例,占19.17%。影响疗效的常见因素有窦口开放过小、有伴发病、未定期冲洗及病理性质4个方面,尤以窦口开放过小和未定期冲洗影响最大。结论:影响霉菌性鼻窦炎鼻内镜手术疗效的原因很多,特别应高度重视患者术中上颌窦窦口扩大开放及术后鼻内镜定期随访冲洗,重视对伴发病的积极处理,重视术后病理检查的结果,尤其对侵袭性霉菌性鼻窦炎患者,术后处理应更积极一些。对变应性鼻炎伴或不伴鼻息肉患者更应进行长期随访和综合治疗。
[关键词] 霉菌性鼻窦炎;鼻内镜;疗效
[中图分类号] R765.4+1[文献标识码]A [文章编号]1673-7210(2010)06(b)-016-03
Research on the factors influencing fungal sinusitis endoscopic surgery
LI Debing, MA Zhiyue
(Department of ENT, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China)
[Abstract] Objective: To research the factors affectting fungal sinusitis endoscopic surgery. Methods: Followed up 120 cases of fungal sinusitis by endoscopic sinus surgery to find the factors influencing efficacy. Results: All patients were followed up for 6 to 36 months, 97 cases were cured, accounting for 80.83%; 23 cases were relapse, accounting for 19.17%. Common factors affecting the efficacy was sinus opening too small, associated with other diseases, no regularly wash, pathological nature of invasive fungal infection and so on, especially sinus opening too small and no regularly wash. Conclusion: There are many factors influencing fungal sinusitis endoscopic surgery, patients should attach great importance especially in the maxillary sinus ostium opening wider and regular follow-up after endoscopic sinus rinse, emphasis on active treatment with the disease, emphasis on pathologic results, particularly in patients with invasive fungal sinusitis, postoperative management should be more positive. With allergic rhinitis and/or nasal polyps should be long-term followed up and given comprehensive treatment.
[Key words] Fungal maxillary sinusitis; Endoscope; Therapeutic effect
霉菌性鼻窦炎以上颌窦发病率最高,其次是筛窦和蝶窦,额窦发病率较低。鼻内镜手术是目前治疗霉菌性上颌窦炎最常用而有效的手术方法,能最大限度地清除病变组织,同时也能保留和恢复鼻腔的生理功能;但受各种因素的影响,部分患者未能达到预期的治疗效果。为寻找影响霉菌性鼻窦炎鼻内镜手术疗效的原因,我院于2007年3月～2009年9月对在我科住院的120例霉菌性鼻窦炎患者,采用鼻内镜下鼻窦开放术治疗霉菌性鼻窦炎,术后随访时间6～36个月,对影响疗效的原因进行分析总结。现报道如下:
1 资料与方法
1.1 一般资料
本组患者120例,其中,男78例,女42例;年龄28～73岁,平均41 ......
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