两种径路治疗真菌性上颌窦炎的临床研究

发布时间：2018-06-19 09:49

本文选题：真菌性 + 两种径路　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的：探讨鼻内镜下中鼻道联合下鼻道开窗术与单纯鼻内镜下上颌窦开放术治疗真菌性上颌窦炎的疗效,分析其病因及治疗方法。方法：回顾性分析我科近年来收治的70例真菌性上颌窦炎患者的临床资料.按照采用不同的手术径路将其分为两组,治疗组：行鼻内镜下中鼻道联合下鼻道开窗术；对照组：行单纯鼻内镜下上颌窦开放术。术后随访3个月～1.5年,平均1年。结果：结合海口及昆明标准对手术疗效进行评估,治疗组35例中治愈32例,好转2例,无效复发1例,总有效率为97.1%%,复发率2.9%。对照组35例中治愈26例,好转6例,无效复发3例,总有效率为91.4%,复发率8.6%。两组患者的临床疗效经统计学分析,P(=0.032)0.05,差异有统计学意义。比较两组患者手术时间、出血量,经统计学分析,差异无统计学意义,P0.05。结论：真菌性上颌窦炎的治疗原则是彻底清除病灶、通畅引流、保留鼻窦正常黏膜。鼻内镜下中鼻道联合下鼻道开窗术治疗真菌性上颌窦炎的临床疗效明显优于单纯鼻内镜下上颌窦开放术,不仅可以更彻底清除病变组织,而且具有创伤小、复发率低、利于术后窦腔冲洗的优点,值得临床上推广应用。
[Abstract]:Objective: to investigate the curative effect of endoscopic middle nasal canal combined with inferior nasal canal fenestration and simple endoscopic maxillary sinus opening in the treatment of fungal maxillary sinusitis, and to analyze the etiology and treatment of fungal maxillary sinusitis. Methods: the clinical data of 70 cases of fungal maxillary sinusitis treated in our department in recent years were analyzed retrospectively. The patients were divided into two groups according to different operative paths: the treatment group was treated with endoscopic middle nasal canal combined with inferior nasal canal fenestration and the control group was treated with simple endoscopic maxillary sinus surgery. Postoperative follow-up ranged from 3 months to 1.5 years, with an average of 1 year. Results: according to the criteria of Haikou and Kunming, 32 cases were cured, 2 cases were improved, 1 case was ineffective, the total effective rate was 97.1 and the recurrence rate was 2.9% in the treatment group. In the control group, 26 cases were cured, 6 cases improved, 3 cases failed to recur, the total effective rate was 91.4 and the recurrence rate was 8.6%. The clinical effects of the two groups were statistically analyzed, and the difference was statistically significant. The operation time and bleeding volume were compared between the two groups, and the difference was not statistically significant (P 0.05). Conclusion: the treatment principle of fungal maxillary sinusitis is to thoroughly clear the lesion, clear the drainage and preserve the normal mucosa of the paranasal sinus. The clinical effect of endoscopic middle nasal canal combined with inferior nasal canal fenestration in the treatment of fungal maxillary sinusitis is significantly better than that of simple endoscopic maxillary sinus surgery. It not only can remove the lesion more thoroughly, but also has less trauma and low recurrence rate. It is beneficial to sinus irrigation after operation and is worth popularizing in clinic.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R765.42

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