单侧鼻窦病变的诊断及临床特征分析

发布时间：2018-04-05 01:25

本文选题：鼻窦疾病　切入点：临床特征　出处：《临床耳鼻咽喉头颈外科杂志》2017年03期

【摘要】：目的:通过分析单侧鼻窦病变患者的临床特征,探讨单侧鼻窦病变的发病规律。方法:对2 480例鼻窦病变患者的临床资料进行统计学分析,并针对部分鼻窦病变类型进行讨论。结果:1 350例(54.4%)双侧鼻窦病变患者的术后病理诊断均为普通的慢性鼻窦炎。1 130例(45.6%)单侧鼻窦病变患者中术后病理提示为慢性鼻窦炎者589例(52.1%),其余541例(47.9%)患者中真菌性鼻窦炎312例(27.6%),内翻性乳头状瘤95例(8.4%),鼻窦囊肿78例(6.9%),恶性肿瘤34例(3.0%),骨瘤及骨纤维异常增生症11例(1%),其他11例(1%)。单侧鼻窦病变中真菌性鼻窦炎患者呈现逐年增多趋势,头面部胀痛(46.8%)、涕血及鼻出血(31.1%)为其常见症状(P0.05)。内翻性乳头状瘤近几年多见,男性好发(77.9%),32.6%的患者存在同侧鼻窦手术史,影像学检查可见窦壁骨质吸收破坏(26.7%)。恶性肿瘤患者约半数为老年人,男性多见(79.4%),涕血及鼻出血(58.8%)为其常见症状(P0.05),影像学可见窦壁骨质吸收破坏(35.3%)。结论:单侧鼻窦病变患者有近半数为非普通炎症性疾病,其中真菌性鼻窦炎及内翻性乳头状瘤、骨瘤、鳞状细胞癌等各种良恶性肿瘤的发生率较高。因此对于这类患者应进行详尽的病史询问,仔细的内镜检查、影像学检查,以免漏诊、误诊。
[Abstract]:Objective: to analyze the clinical features of unilateral paranasal sinus disease and to explore the pathogenesis of unilateral paranasal sinus disease.Methods: the clinical data of 2 480 patients with paranasal sinus diseases were analyzed statistically, and some types of sinus lesions were discussed.Results the postoperative pathological diagnosis of 1 350 patients with bilateral sinusitis was normal chronic sinusitis (1.130 cases with chronic sinusitis) 589 cases with chronic sinusitis (589 cases with chronic sinusitis) and 541 cases with chronic sinusitis (47.9%).There were 312 cases of sinusitis, 95 cases of inverted papilloma, 78 cases of sinus cyst, 34 cases of malignant tumor, 11 cases of osteoma and fibrous dysplasia, and 11 cases of other 11 cases.The incidence of fungal sinusitis in patients with unilateral sinusitis was increasing year by year, and 46.8% of head and face distended pain, 31. 1% of snot blood and epistaxis) were common symptoms (P 0. 05).In recent years, 77.9% of the male patients with varus papilloma had ipsilateral sinus surgery. The bone resorption and destruction of the sinus wall were found in 26.7% of the male patients.About half of the patients with malignant tumors were elderly, and 79.4% of the males were the most common symptoms. The common symptoms were snot blood and epistaxis (58. 8%). The bone resorption and destruction of the sinus wall could be seen in the imaging images with a total of 35. 3%.Conclusion: nearly half of the patients with unilateral sinus diseases are non-common inflammatory diseases. The incidence of fungal sinusitis, inverted papilloma, osteoma, squamous cell carcinoma and other benign and malignant tumors is higher.Therefore, we should make detailed history inquiry, careful endoscopy and imaging examination to avoid missed diagnosis and misdiagnosis.
【作者单位】：上海交通大学医学院附属瑞金医院耳鼻咽喉科;
【分类号】：R765.4

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