中老年人真菌球性鼻窦炎临床特征及鼻内镜手术观察

doi:10.6040/j.issn.1673-3770.0.2016.038

摘要/Abstract

摘要： 目的探讨中老年人真菌球性鼻窦炎的临床特征、鼻内镜手术治疗的效果以及术后复发的处理。方法总结60例中老年真菌球性鼻窦炎患者的临床资料,分析该疾病的临床特征。患者均行鼻内镜手术治疗,手术前后行视觉模拟量表评分及鼻内镜检查评分。术后复发者行上颌窦冲洗。结果 60例中临床主要症状依次为流涕、鼻塞、鼻腔异味、鼻涕倒流和涕中带血,常见体征为中鼻道狭窄及黏膜肿胀、脓性分泌物或干酪样物附着及息肉阻塞,76.92%具有典型的CT特征。术后视觉模拟量表及鼻内镜检查评分均较术前降低(P<0. 01),术后术腔完全恢复需6个月。4例复发患者通过上颌窦冲洗病情均完全控制。结论中老年真菌球性鼻窦炎临床特征及鼻腔检查结果各异,CT扫描对诊断有特殊价值。鼻内镜手术是治疗此病的有效手段,术后病情控制需6个月时间,上颌窦冲洗在治疗术后复发中起重要作用。

关键词: 临床特征, 真菌病, 鼻窦炎, 鼻内镜外科手术

Abstract: Objective To investigate the clinical characters of the elderly patients with fungus ball sinusitis, and assess the therapeutic effect of endoscopic sinus surgery and management for recurrence. Methods The clinical data of 60 cases were analyzed. All the patients were performed endoscopic sinus surgeries and Visual Analog Scale(VAS)and the endoscopic examination. Patients with post-operative recurrence were done the maxillary sinus irrigation. Results In this group, the main clinical symptoms were runny nose, stuffy nose, nasal odor, postnasal drip and drip with blood, and the common signs were the middle nasal meatus stenosis and mucosal swelling, purulent secretions or caseous matter attachment and nasal meat obstruction, 76.92 percent of the patients had typical CT features. Both the Visual Analog Scale(VAS)and the score of endoscopic examination after the surgery were significantly lower than those before the surgery(p-value <0.01). It took 6 months that the operated cavity fully recovered. 4 recurrent cases were under complete control through irrigation of maxillary sinus. Conclusion The clinical characters and nasal examination are different in elderly patients with fungus ball sinusitis, CT scanning has special value for diagnosis. Endoscopic sinus surgery is an efficient way for this disease and irrigation of the maxillary sinus plays an important role for post-operative recurrence.

Key words: Clinical characters, Endoscopic sinus surgical procedures, operative, Fungal disease, Nasosinusitis

中图分类号:

R765.4

刘英,季青,封新荣,刘文. 中老年人真菌球性鼻窦炎临床特征及鼻内镜手术观察[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 98-100.

LIU Ying, JI Qing, FENG Xinrong, LIU Wen. Investigations on the clinical features and endoscopic sinus surgery for the elderly patients with fungus ball sinusitis.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(4): 98-100.

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