鼻腔鼻窦结构重建在鼻窦炎手术中的作用

发布时间：2018-04-05 23:37

本文选题：解剖学　切入点：慢性鼻-鼻窦炎　出处：《大连医科大学》2012年硕士论文

【摘要】：目的：探讨鼻腔鼻窦结构异常与慢性鼻窦炎的相关性，探讨鼻腔鼻窦不同的结构异常在慢性鼻窦炎发生发展中的作用。方法：回顾性分析2009年12月—2011年12月在我院接受功能性鼻内镜手术的患者235例，根据鼻窦CT、鼻内镜下及术中所见的情况，记录鼻中隔偏曲、中鼻甲肥大、泡状中鼻甲、中鼻甲反张、钩突肥大的解剖变异情况，本研究根据慢性鼻-鼻窦炎患者是否合并有鼻息肉生长分为两大组，A组：单纯型慢性鼻窦炎（保守治疗无效）；B组：慢性鼻窦炎伴有鼻息肉；同时，按照检查结构将鼻息肉分为3级：I级：单发鼻窦炎伴单发鼻息肉；II级：多发鼻窦炎伴多发鼻息肉；III级：全组鼻窦炎伴多发鼻息肉。对合并鼻息肉的鼻窦炎患者与不伴息肉的鼻窦炎患者在鼻腔结构解剖变异方面相比较，分析其相关性。结果：功能性鼻内镜手术治疗慢性鼻-鼻窦炎总的治愈率为78.9%，好转率为17.3%，无效率为3.8%。不同组别的鼻窦炎患者中，，鼻中隔偏曲、中鼻甲肥大及钩突肥大检出率差异有统计学意义；中鼻甲反向偏曲、泡状中鼻甲及下鼻甲肥大检出率无明显统计学意义；伴有鼻息肉的慢性鼻-鼻窦炎患者鼻腔鼻窦结构异常的检出率高于单纯型慢性鼻-鼻窦炎患者，且随病变的严重程度增加，鼻腔鼻窦解剖异常检出率增高；在不同组别的慢性鼻-鼻窦炎患者中，不同类型的鼻中隔偏曲检出率差异有统计学意义（x2=6.64P0.05），且鼻中隔高位偏曲的患者检出率高于非鼻中隔高位偏曲患者。结论：鼻腔鼻窦结构异常与慢性鼻-鼻窦炎的发生有着密切的关系，其中较为常见的结构异常为鼻中隔偏曲、中鼻甲肥大及钩突肥大。
[Abstract]:Objective: to investigate the relationship between the abnormal structure of nasal cavity and paranasal sinus and chronic sinusitis, and to explore the role of different structural abnormalities of nasal cavity and paranasal sinus in the occurrence and development of chronic sinusitis.Methods: 235 patients undergoing functional endoscopic sinus surgery in our hospital from December 2009 to December 2011 were retrospectively analyzed. According to CT, endoscopic and intraoperative findings, nasal septum deviation, middle turbinate hypertrophy, and bubbly middle turbinate were recorded.Anatomic variation of middle turbinate regurgitation and uncinate process hypertrophy,In this study, patients with chronic rhinosinusitis and nasal polyps were divided into two groups: simple chronic sinusitis (group B: chronic sinusitis with nasal polyps) and chronic sinusitis with nasal polyps.The nasal polyps were divided into three grades according to the examination structure: single sinusitis with single nasal polyp grade II, multiple sinusitis with multiple nasal polyp grade III: sinusitis with multiple nasal polyps.To compare the anatomic variation of nasal cavity structure between sinusitis patients with nasal polyps and sinusitis patients without polyps, and analyze its correlation.Results: the total cure rate of functional endoscopic surgery for chronic rhinosinusitis was 78.9, the improvement rate was 17.3and the inefficiency was 3.8%.The positive rates of nasal septum deviation, middle turbinate hypertrophy and uncinate process hypertrophy were significantly different among different groups of sinusitis patients, but there was no significant difference in the detection rate of middle turbinate reverse deviation, bubble middle turbinate and inferior turbinate hypertrophy.The detection rate of nasal cavity and sinusitis in patients with chronic rhinosinusitis with nasal polyps was higher than that in patients with simple chronic rhinosinusitis.In different groups of patients with chronic rhinosinusitis, the positive rate of nasal septum deviation was significantly higher in patients with nasal septum deviation than that in non-nasal septum high deviation patients.Conclusion: the abnormal structure of nasal cavity and sinusitis is closely related to the occurrence of chronic rhinosinusitis, among which the common structural abnormalities are nasal septum deviation, middle turbinate hypertrophy and uncinate process hypertrophy.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R765.9

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