鼻内镜联合下鼻道开窗双径路治疗上颌窦难治性病变的效果

发布时间：2018-04-17 00:01

本文选题：鼻内镜 + 下鼻道开窗　；参考：《中国医药导报》2016年06期

【摘要】：目的分析鼻内镜联合下鼻道开窗双径路治疗上颌窦难治性病变的效果。方法回顾性分析2013年1月~2015年5月四川省宜宾市第二人民医院收治的102例(115侧)上颌窦难治性病变患者的临床资料,患者术前均行鼻窦冠状位及水平位CT、鼻内镜检查,且经术后病理检查明确诊断。根据手术方式不同,将患者分为观察组和对照组。观察组52例患者采用鼻内镜联合下鼻道开窗双径路手术,对照组50例采用传统的单纯鼻内镜手术治疗。术后随访观察并比较两种术式的治疗效果及预后情况。结果两组患者性别、年龄、疾病类型比较,差异均无统计学意义(P0.05)。观察组总有效率为100.0%,对照组总有效率为84.0%,差异有统计学意义(P0.05)。所有患者术后均随访5个月~1年,观察组患者术后复查CT,未见原发部位病变复发,窦腔黏膜均未出现纤维化,术腔清理干净、无肿胀及脓性分泌物,上颌窦均自然开口,且通畅,创面愈合良好;对照组患者术后复查CT,5例患者出现病变在原手术部位复发,窦腔黏膜出现纤维化表现。结论鼻内镜联合下鼻道开窗双径路治疗上颌窦难治性病变可彻底清除病变,复发率低,疗效肯定,值得临床推广应用。
[Abstract]:Objective to analyze the effect of endoscopic approach combined with double-path fenestration in the treatment of refractory maxillary sinus lesions.Methods the clinical data of 102 patients with refractory maxillary sinus lesions admitted to Yibin second people's Hospital of Sichuan Province from January 2013 to May 2015 were retrospectively analyzed. The patients were performed coronal and horizontal CTS and nasal endoscopy before operation.The diagnosis was confirmed by postoperative pathological examination.Patients were divided into observation group and control group according to the different operation methods.The observation group (52 cases) were treated by nasal endoscope combined with the double path of nasal canal fenestration, and the control group (50 cases) were treated by traditional endoscopic surgery.The effect and prognosis of the two methods were observed and compared.Results there was no significant difference in sex, age and disease type between the two groups (P 0.05).The total effective rate was 100.0in the observation group and 84.0 in the control group. The difference was statistically significant (P 0.05).All the patients were followed up for 5 months to 1 year after operation. The patients in the observation group had no recurrence of primary lesions, no fibrosis of sinus mucosa, no swelling and purulent secretion, and the maxillary sinuses opened naturally.In the control group, 5 patients with CTU had recurrence in the original site and fibrosis in the sinus mucosa.Conclusion nasal endoscopy combined with double approach of fenestration for the treatment of intractable maxillary sinus lesions can completely clear the lesions, the recurrence rate is low, the curative effect is positive, and it is worthy of clinical application.
【作者单位】：四川省宜宾市第二人民医院耳鼻喉科;四川省宜宾市第二人民医院医教部;
【分类号】：R765.9

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