鼻中隔穿孔的原因和部位分析

发布时间：2018-04-16 11:14

本文选题：鼻中隔穿孔 + 鼻中隔软骨部　；参考：《广西医科大学》2010年硕士论文

【摘要】： 目的：通过对鼻中隔穿孔发生的原因和部位进行分析,探讨与鼻中隔穿孔发生的有关因素,以及鼻中隔穿孔的原因和部位关系,为临床实践中预防鼻中隔穿孔的发生提供依据。方法：对57例经广西医科大学耳鼻咽喉头颈外科确诊的鼻中隔穿孔患者的临床资料进行回顾性分析,包括穿孔的发生原因、部位、大小、性别及年龄等并进行相关分析。结果：在鼻中隔穿孔的发生原因中,行Killian氏鼻中隔矫正术后发生穿孔30例,恶性肿瘤化疗后穿孔5例,其他原因如特殊炎症、鼻腔治疗后引起穿孔(梅毒、天花、炎症等)5例,肿瘤侵犯引起穿孔2例,外伤后引起穿孔2例,鼻腔异物引起穿孔2例,鼻腔填塞后引起穿孔1例,原发性穿孔7例。穿孔部位位于鼻中隔软骨部47例,骨部10例；按穿孔直径大小将鼻中隔穿孔分3度：直径小于0.5cm为小穿孔,0.5～1.5cm为中度穿孔,大于1.5cm为大穿孔,在本组病例中,小穿孔14例,中度穿孔15例,大穿孔28例。经卡方分析,不同部位穿孔原因的构成有差异性,将穿孔原因进行两两比较(检验水准为0.002), Killian氏鼻中隔术后穿孔占总穿孔例数的比例与其他原因穿孔占总穿孔例数的比例的差别均有统计学意义(P=0.000),而其他原因引起穿孔占总穿孔例数的比例之间的差别均无统计学意义。对穿孔原因与部位进行卡方分析,发现Killian氏鼻中隔矫正术后穿孔、化疗后穿孔、肿瘤侵犯致穿孔均与穿孔部位有相关性,P值分别为0.049、0.033和0.028, Killian氏鼻中隔矫正术后发生穿孔多位于软骨部,化疗后穿孔多位于骨部,肿瘤侵犯致穿孔多位于骨部；鼻中隔穿孔原因和部位均与穿孔大小、性别、年龄的统计学分析无相关性。结论：Killian氏鼻中隔矫正术是导致鼻中隔穿孔的主要原因；其穿孔部位多位于软骨部。鼻中隔穿孔原因和部位均与穿孔大小、性别、年龄无相关性。
[Abstract]:Objective: to analyze the causes and location of nasal septum perforation, to explore the related factors of nasal septal perforation, as well as the relationship between the causes and location of nasal septal perforation, so as to provide the basis for the prevention of nasal septal perforation in clinical practice.Methods: the clinical data of 57 patients with perforation of nasal septum confirmed by otolaryngology and head and neck surgery of Guangxi Medical University were analyzed retrospectively, including the cause, location, size, sex and age of perforation.Results: among the causes of nasal septum perforation, there were 30 cases of perforation after Killian's correction of nasal septum, 5 cases of malignant tumor perforation after chemotherapy, other reasons such as special inflammation, 5 cases of perforation (syphilis, smallpox, inflammation, etc.) after nasal cavity treatment.There were 2 cases of perforation caused by tumor invasion, 2 cases of perforation caused by trauma, 2 cases of perforation caused by foreign body in nasal cavity, 1 case of perforation caused by nasal packing, and 7 cases of primary perforation.According to the size of perforation diameter, the perforation of nasal septum was divided into three degrees: the diameter less than 0.5cm was 0.5 ~ 1.5cm, the diameter of small perforation was 0.5 ~ 1.5cm, and the diameter of 1.5cm was large perforation. In this group, 14 cases were small perforation.There were 15 cases of moderate perforation and 28 cases of large perforation.By chi-square analysis, the causes of perforation in different parts are different.Comparing the causes of perforation (test level: 0.002), the ratio of perforation to total perforation after Killian's nasal septum operation is statistically different from the proportion of perforation to total perforation due to other causes.There was no significant difference in the proportion of perforations to the total number of perforations.The causes and location of perforation were analyzed by chi-square analysis. It was found that Killian's nasal septum was perforated after orthopedic surgery and perforation after chemotherapy.Perforation caused by tumor invasion was correlated with the location of perforation (P = 0.049, 0.033 and 0.028, respectively). Perforation after Killian's nasal septum orthopedic surgery was mostly located in cartilage, perforation after chemotherapy was in bone, and perforation caused by tumor invasion was mostly located in bone.The cause and location of nasal septum perforation were not correlated with the size, sex and age of perforation.Conclusion the main cause of nasal septum perforation is the correction of the nasal septum by Wechillian's surgery, and most of the perforations are located in the cartilage.The cause and location of nasal septum perforation were not correlated with the size, sex and age of perforation.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R765

【参考文献】