非侵袭型真菌性鼻-鼻窦炎CT影像及诊治分析

发布时间：2018-11-13 16:53

【摘要】：目的:探讨非侵袭型真菌性鼻-鼻窦炎的CT影像学特征和临床治疗。方法:对262例非侵袭型真菌性鼻-鼻窦炎患者的症状和体征特点、CT影像学结果、治疗过程及病理结果进行回顾性分析。结果:262例患者中男93例,女169例,258例诊断为真菌球,4例为变应性真菌性鼻-鼻窦炎。临床表现有鼻阻、流涕、头昏、头痛等。术前鼻窦CT检查中有146例提示真菌性鼻-鼻窦炎。所有患者均行手术治疗,同期行鼻中隔偏曲矫正的有27例。病理全部确诊为真菌感染,术后定期复查,配合鼻腔冲洗和激素等治疗,其中4例复发。结论:术前CT检查对诊断非侵袭型真菌性鼻-鼻窦炎具有重要的参考价值;鼻中隔偏曲是否影响鼻窦真菌的定植还需进一步研究;鼻窦真菌球的治疗主要依靠经鼻内镜手术配合术后鼻腔冲洗及鼻部应用激素,而变应性真菌性鼻-鼻窦炎除上述治疗外还需进一步结合口服激素及其他治疗方式。
[Abstract]:Objective: to investigate the CT imaging features and clinical treatment of non invasive fungal rhinosinusitis. Methods: the symptoms and signs of 262 cases of noninvasive fungal rhinosinusitis, CT imaging results, treatment process and pathological results were retrospectively analyzed. Results: among 262 patients, 93 were male, 169 were female, 258 were fungal ball and 4 were allergic fungal rhinosinusitis. Clinical manifestations include nasal obstruction, runny, dizziness, headache, and so on. Preoperative CT examination of paranasal sinuses showed fungal rhinosinusitis in 146 cases. All patients were treated surgically, and 27 patients underwent nasal septum deviation correction at the same time. All the cases were diagnosed as fungal infection. After operation, 4 cases recurred with nasal irrigation and hormone therapy. Conclusion: preoperative CT examination has important reference value in the diagnosis of noninvasive fungal rhinosinusitis. The treatment of fungal ball of paranasal sinus mainly depends on nasal cavity irrigation and nasal hormone application after nasal endoscopic surgery, while allergic fungal rhinosinusitis should be further combined with oral hormone and other treatment methods in addition to the above treatment.
【作者单位】：西南医科大学附属医院耳鼻咽喉头颈外科;西南医科大学附属医院急诊医学部;
【基金】：四川省卫生和计划生育委员会科研项目(编号:150071) 西南医科大学青年基金项目(编号:2016-47-40)
【分类号】：R765;R816.96

【相似文献】