中药喷雾治疗副鼻窦炎60例

1996～1998年,我们用中药喷雾治疗急、慢性副鼻窦炎60例,疗效满意。1　临床资料1.1　一般情况　本组男36例,女24例;年龄16～52岁,平均33岁。其中16～21岁18例,22～35岁31例,35～52岁11例。病程:6个月10例,1年14例,2年12例,3年16例,4年8例。病变部位:额窦16例,筛窦12例,上颌窦32例。表现为全身不适、精神不振或烦躁、食欲不佳、易倦、失眠、头昏等。局部表现为流黄色、绿色或灰绿色脓涕,鼻不通气、嗅觉障碍、局部疼痛或头痛。患牙源性上颌窦炎时,常伴有同侧上列牙痛;患后组鼻窦炎时,可发生颈项和肩部肌肉疼痛和压痛。慢性鼻窦炎头痛较轻,多表…     

霉菌性副鼻窦炎CT表现和临床、病理分析

随着抗生素及皮质激素的广泛应用，鼻腔、鼻窦霉菌病日趋增多。CT能准确估计副鼻窦炎性病变范围和程度，已成为副鼻窦根治术和功能性鼻内镜术前必不可少的检查。笔者回顾性分析我院及外院近10年来作CT检查并经手术、病理证实的31例霉菌性副鼻窦炎的临床、病理及CT资料．以便提高对霉菌性副鼻窦炎的认识。     

飞行员副鼻窦炎致眶尖综合征一例

患者，男性，29岁，歼六飞行员，飞行时间1200h。因疲劳，受凉后出现咽癌、干咳、耳塞、鼻腔内异物感，自服“康泰克”抗感冒治疗略好转。但几天后出现左须顶部剧烈疼痛，左眼胀痛，视物模糊，呈双影。1993年5月ZI日入我院。检查见思者左眼外突，眼脸下垂，左眼球向内、上、下方向活动受限，球结膜充血，视力右1．2左O．6，左侧瞳孔较右侧偏大，对光反射迟钝，左视乳头轻度充血水肿。鼻腔检查鼻中隔向左偏曲，无异常分泌物。同时作脑CT，核磁共振脑动脉造影检查均无异常。初诊为海绵窦炙，采用青霉素，灭摘录、地塞米极综合抗炎治疗，疗效…     

霉菌性副鼻窦炎的CT表现(附11例分析)

本文分析霉菌性副鼻窦炎的CT表现，旨在探讨其诊断价值，以提高本病诊断的准确性。     

霉菌性副鼻窦炎的CT特征

目的探讨霉菌性副鼻窦炎的CT特征。方法回顾分析20例经手术病理证实的霉菌性副鼻窦炎的CT表现。结果单侧副鼻窦发病18例,双侧副鼻窦发病2例,全部病变均累及上颌窦,累及2个以上副鼻窦腔8例,病变侵犯后鼻孔2例。霉菌性副鼻窦炎的CT表现主要为病变窦腔内充满软组织影,密度增高,不均匀,病灶内出现点状、条状钙化灶,窦腔骨壁增厚伴破坏,窦腔缩小。结论霉菌性副鼻窦炎的CT表现具有单侧发病为主,窦腔内点状、条状钙化灶,窦腔骨壁增厚伴破坏以及窦腔缩小等特征。CT可为诊断本病提供重要信息,但确诊需要组织学和细菌学检查。     

青少年副鼻窦炎CT检查的临床意义（附100例分析）

目的：用高分辨率ＣＴ对青少年慢性鼻窦炎的发生进行影像学分析。材料与方法：收集４￣１７岁１００例。并将其影像学资料分成少年组及青少年组，并对其结果进行分析比较。结果：９０％慢性副鼻窦炎的发生与窦口鼻道复合体区的炎性病变有关。结论：窦口鼻道复合体区是慢性副鼻窦炎形成的初发部位。     

霉菌性副鼻窦炎的CT诊断(附11例分析)

<正>霉菌性副鼻窦炎与一般鼻窦炎,鼻息肉相似,所以容易造成误诊。笔者回顾性分析我院近5年CT检查并经手术病理证实的11例霉菌性副鼻窦炎病例的临床资料,旨在提高对霉菌性副鼻窦炎的认识。1资料与方法1.1一般资料本组11例患者中,男4例,女7例,年龄23~75岁,病程1~7个月。患者主要临床症状中有鼻腔流涕、头痛者8例,鼻塞者7例,鼻涕带血者2例,面部疼痛     

霉菌性副鼻窦炎CT表现和病理分析

目的　报告２０例病理证实的霉菌性副鼻窦炎并回顾文献,旨在提高对此病的认识探讨ＣＴ的诊断价值。材料和方法２０例均行轴位（８例同时行冠状位）ＣＴ扫描,分析ＣＴ表现和病理结果。结果　病理所见２０例中１５例为曲霉菌,３例为毛霉菌,２例不能分型。ＣＴ显示２０例一侧上颌窦均受累,５例同侧筛窦亦被侵犯。１８例上颌窦炎性病变中见斑点斑块状钙化。１８例见上颌窦窦壁的骨质侵蚀破坏和增生硬化。结论　ＣＴ尤其是冠状位ＣＴ是显示副鼻窦的解剖结构和诊断霉菌性副鼻窦炎的重要手段。     

100例儿童正常副鼻窦的MRI表现

目的: 探讨1～14岁儿童正常副鼻窦的MRI表现.材料和方法: 观察和分析100例无副鼻窦炎的1～14岁儿童副鼻窦MRI图像.结果: 各窦腔气化及窦壁粘膜发育有差异,额窦及蝶窦窦腔气化比例随年龄增长呈逐渐上升趋势.结论: 熟悉儿童正常副鼻窦的MRI表现,有助于对其病变的诊断.     

Recent trends in the diagnosis and treatment of sinusitis

The almost simultaneous introduction of nasal endoscopy and CT imaging led to better understanding of normal and pathologic function of the paranasal sinuses. Diagnosis and treatment of many paranasal sinus diseases improved considerably. Endoscopy and CT are not concurrential; they are complementary, but they have specific strengths and weaknesses, as well as specific indications and considerations. Staging systems for chronic sinusitis are currently used based on CT findings and response to medical therapy. Functional endoscopic sinus surgery (FESS) has become the standard procedure for most surgical cases of chronic sinusitis. Indications for FESS have enlarged beyond chronic sinus problems and even beyond the borders of the sinuses. Functional endoscopic sinus surgery aims to gain maximal result (restoring normal function) with minimal trauma and morbidity. Correspondence to: M. Jorissen     

Waters' view in children with sinusitis

Waters' occipito-mental view of 433 children with prolonged upper respiratory infection was reviewed. In about 30% of cases no abnormal findings were detected. 68% had bilateral sinusitis, most frequently total opacity or air-fluid level, especially in children before school age. Seven children (1.7%) had polypoid lesions. Reexamination was done in 15% of cases. In children below four years of age Waters' view is not always technically optimal. Hence x-ray findings should be assessed critically. After the children have reached school age, radiographic evaluation of sinuses becomes as reliable as with adults.     

Vein of Galen aneurysmal malformation: diagnosis and treatment of 13 children with extended clinical follow-up

BACKGROUND AND PURPOSE: We herein present our experience in diagnosing and treating 13 children with vein of Galen aneurysmal malformations (VGAM), with an emphasis on possible prognostic indicators, endovascular strategies, factors affecting treatment during the neonatal period, and long-term follow-up. With this review, we hope to identify those factors that have the most significant prognostic value in determining long-term outcomes in children with VGAM. METHODS: We retrospectively reviewed the radiology studies, hospital charts, and outpatient clinic chart notes (when applicable) of 13 children evaluated and treated for VGAM at a single tertiary care pediatric hospital. Clinical presentation, diagnostic methods, treatment strategies, and outcome were documented for each child. The present neurologic status and level of function of each patient was determined by review of the outpatient charts and direct contact with the clinicians who were conducting the follow-up. Outcome was graded on a 5-point scale, ranging from 0 (death) to 4 (normal), taking into account only neurologic and developmental characteristics. RESULTS: Eight of 13 patients presented as neonates with congestive heart failure. The other five patients ranged in age from 4 months to 13 years at the time of presentation. The five patients presenting outside of the neonatal period achieved normal or near-normal outcomes. Two of the eight patients presenting during the neonatal period achieved normal or near-normal outcomes, one experienced significant impairment, and the other five died. We were unable to identify significant differences in outcome on the basis of differences in treatment strategies. CONCLUSION: Our experience confirms that children with VGAM presenting during the neonatal period have a generally much worse prognosis than do those presenting later in childhood. Complicating factors in the management and treatment of these children are discussed in light of their impact on outcome.     

小儿原发性睾丸肿瘤诊治分析

目的 探讨小儿原发性睾丸肿瘤的诊治。方法 分析小儿原发性睾丸肿瘤32例,其中卵黄囊瘤16例,畸胎瘤10例,胚胎型横纹肌肉瘤4例,表皮样囊肿2例。所有病例均行手术治疗,术中行冰冻切片活检,良性者行保留睾丸手术;恶性者行根治性睾丸切除、腹股沟淋巴结清扫术。20例恶性肿瘤病人术后行系统化疗。结果 术中冰冻病理与术后病理结果完全一致。24例获得随访,除4例卵黄囊瘤病人术后1年内因广泛转移死亡外,其余病例均无瘤生存4个月至7年,平均73个月。结论 超声对小儿原发性睾丸肿瘤有诊断价值,列为常规检查。手术为首选的治疗,术中冰冻切片活检非常必要。睾丸良性肿瘤患儿行保留睾丸手术对其生理功能、美观及心理方面均有重要意义。对预后好的病例尽量减少化疗,对预后差的病例应加强化疗。     

Fungal sinusitis: diagnosis with CT and MR imaging

Of 293 patients who underwent computed tomography (CT), surgery, and pathologic examination for chronic sinusitis, 25 had a diagnosis of fungal sinusitis at pathologic examination. Of these, 22 had foci of increased attenuation at CT (in four patients the mean representative CT number [Hounsfied unit] was 122.2 HU [SD, 8.2 HU]), and three did not. Of the 22, 19 patients (76%) met the CT criterion of this study (there was a 12% false-positive and a 12% false-negative diagnostic rate). Six of the 19 patients and one additional patient underwent magnetic resonance (MR) imaging, and all demonstrated remarkably hypointense signal characteristics on T2-weighted images. The findings at MR imaging therefore appear more characteristic of fungal sinusitis than the findings at CT. Furnace atomic absorption spectrometry showed increased concentrations of iron and manganese in mycetoma compared with their concentrations in bacterially infected mucus. This finding and the presence of calcium in the fungal concretion may explain the hypointense T2-weighted signal on MR images.     

真菌性蝶窦炎的影像诊断和鉴别诊断

目的:探讨蝶窦真菌感染的影像学特征、诊断和鉴别诊断。方法:回顾性分析11例经病理证实的真菌性蝶窦炎的临床和影像学检查资料。结果:CT与MRI表现为窦腔内结节样软组织密度影8例(73%);伴有沙粒状、小条片状、团块状的钙化6(45%)例;累及后组筛窦5例(45%),伴窦腔扩大7例(64%);局限性骨质增生和破坏4例(36%)。结论:真菌性蝶窦炎具有较特征性影像学表现,鉴别诊断要考虑一般性炎症、息肉、粘液囊肿和肿瘤。     

儿童传染性单核细胞增多症多个临床检测指标的诊断价值

 目的探讨儿童传染性单核细胞增多症(infectiousmononucleosis,IM)的检测指标的诊断价值。方法观察101例IM患儿发热天数与多种检测指标,如EB病毒DNA(DNAcopiesofEpstein-Barrvirus,EBV-DNA)、EB衣壳蛋白(viralcapsidantigen,VCA)抗体、异型淋巴细胞、血液中WBC和ALT等指标之间的关系。结果IM患儿的发热天数与多种检测指标的关系用散点图趋势分析提示,不同的检测指标随着发热天数变化趋势不同。IM患儿在发热早期和中期(发热8d内),EBV-DNA和IgG-VCA的检出阳性率较高(分别是77.2%和76.9%);发热后期EBV-DNA和IgG-VCA(发热12d后)迅速下降。结论在IM患儿发热的初期和中期检测EBV-DNA和VCA的IgG抗体,有助于患儿的特异性诊断。