局部麻醉钬激光辅助下治疗鼻腔黏膜接触点性头痛的疗效观察

发布时间：2019-02-19 14:48

【摘要】：目的:研究局部麻醉钬激光辅助下治疗鼻腔黏膜接触点性头痛的治疗效果。方法:在局部麻醉钬激光辅助下对32例鼻腔黏膜接触点性头痛患者进行术前鼻内镜和鼻窦CT检查,明确显示鼻中隔棘突与鼻甲和(或)鼻腔外侧壁之间的接触点,同时排除明显的鼻窦炎表现。采用4%丁卡因作用于头痛患者鼻腔黏膜接触点区域后,头痛完全消失或头痛强度减少50%以上。对所有患者进行术前及术后30个月标准化疗效问卷评估。结果:术后随访30个月,其中9例患者(28.1%)疼痛完全缓解;19例(59.4%)头痛强度评分改善;4例(12.5%)术后无效。所有患者均未出现鼻中隔穿孔或血肿等并发症。结论:术前鼻窦CT和鼻内镜检查能较准确地发现鼻腔黏膜接触点性头痛接触点的部位,丁卡因试验阳性提示可能有较好的手术效果。局部麻醉钬激光辅助下治疗鼻腔黏膜接触点性头痛短期效果明显,并发症少。
[Abstract]:Objective: to study the therapeutic effect of local anesthesia assisted with holmium laser on nasal mucosal contact point headache. Methods: 32 cases of nasal mucosal contact-point headache were examined by endoscopic and sinus CT under local anesthesia assisted by holmium laser. The contact points between the septal spinous process and the Concha and / or the lateral wall of nasal cavity were clearly displayed. At the same time, the obvious nasal sinusitis was excluded. After 4% tetracaine was used in nasal mucosal contact area of headache patients, headache disappeared completely or headache intensity decreased by more than 50%. All patients were assessed with standardized efficacy questionnaire before and 30 months after operation. Results: following up for 30 months, 9 cases (28.1%) had complete pain relief, 19 cases (59.4%) had improved headache intensity score, 4 cases (12.5%) had no effect after operation. No complications such as nasal septum perforation or hematoma were found in all patients. Conclusion: preoperative CT and endoscopic examination of nasal sinuses can accurately identify the contact points of nasal mucosal contact point headache. The positive results of tetracaine test may have a better surgical effect. The treatment of nasal mucosal contact-point headache with local anesthesia and holmium laser has obvious short-term effect and few complications.
【作者单位】：卫生部北京医院耳鼻咽喉科;
【基金】：首都医学发展科研基金项目(No:2009-3018)
【分类号】：R765

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