变应性鼻炎与慢性鼻窦炎的关系

目的:观察常年性变应性鼻炎患者鼻窦炎发生的原因及发生率。方法:回顾性分析57例常年性变应性鼻炎患者的临床资料。结果:18例并发鼻窦炎,发生率为32%;其中17例伴有不同程度不同类型的鼻腔解剖结构异常,包括鼻中隔偏曲、中鼻甲气化、钩突肥大、中鼻甲曲线异常和鼻丘气房过度发育     

慢性鼻窦炎鼻息肉与变应性因素相关性的探讨

目的 探讨变应性因素在慢性鼻窦炎鼻息肉发病中的作用。方法回顾性分析1882例慢性鼻窦炎鼻息肉患者术前鼻腔分泌物涂片嗜酸粒细胞及变应原皮肤试验检查结果，并将其变应性症状和体征出现的比例与临床分型分期加以比较。结果①1882例慢性鼻窦炎鼻息肉患者中60．4％(1137例)的患者伴有不同程度的变应性症状和体征，25．3％(477例)的患者合并变应性鼻炎，2．1％(39例)的患者合并支气管哮喘；②在Ⅰ型(708例)和Ⅱ型(823例)各分期的患者中，合并变应性鼻炎及支气管哮喘的发生率和嗜酸粒细胞、皮肤变应原试验阳性率以及变应性鼻炎临床症状出现的百分率分别由低到高出现，Ⅱ型3期各项比例最高；③42．2％(795例)的患者变应原皮肤试验阳性，其中94．3％对常年性变应原呈阳性反应；④26．3％(495例)的患者伴有变应性鼻炎的临床症状，其中99．8％(494／495例)为常年性发作；⑤有前期手术史的病例占38．9％(732例)，其中合并变应性鼻炎者占有前期手术史例数的38．3％(280例)，占合并变应性鼻炎患者的58．7％(477例)。结论变应性因素特别是常年性变应性鼻炎与慢性鼻窦炎鼻息肉的病变程度和病变范围有关。同时变应性鼻炎也促进了疾病的复发。     

慢性鼻窦炎与变应性鼻炎的相关性

慢性鼻窦炎与变应性鼻炎都是常见的上呼吸道炎症。国内统计患病率分别为8．0％和9．8％。变态反应是慢性鼻窦炎的发病因素之一，而慢性鼻窦炎常伴有变应性鼻炎，二者关系密切。国外资料显示以常年性变应性鼻炎为主要诊断的患者中超过50％有鼻窦X线异常表现；而以慢性鼻窦炎为主要诊断的患者中伴有变应性鼻炎者高达54％。本文就2001年6月。     

聚焦超声联合下鼻甲手术治疗变应性鼻炎并下鼻甲结构异常疗效分析

目的探讨鼻内镜下聚焦超声联合下鼻甲手术治疗变应性鼻炎并下鼻甲结构异常的疗效及并发症情况。方法确诊为常年性变应性鼻炎并下鼻甲结构异常患者142例,根据患者自愿接受手术情况,随机分为A、B两组。A组行聚焦超声联合下鼻甲结构异常矫正手术治疗;B组单纯行聚焦超声治疗。参照我国兰州标准(2004年),对术前及术后症状和体征评分,评定疗效。结果治疗后3个月时两组总有效率100%;6个月时两组总有效率分别为:A组94.54%,B组88.51%,两组之间无明显疗效差异;12个月时两组总有效率分别为:A组92.73%,B组75.86%,两组之间疗效差异有统计学意义,A组疗效明显高于B组。结论伴有下鼻甲结构异常的常年性变应性鼻炎患者,行聚焦超声联合下鼻甲结构异常手术治疗效果优于单纯聚焦超声治疗,近期可取得较好疗效。     

鼻腔神经部分切断术及下鼻甲粘骨膜下剥离术治疗变应性鼻炎18例临床分析

目的：观察鼻腔神经部分切断术和下鼻甲粘骨膜下血管神经离断术对变应性鼻炎的疗效。方法：对18例常年性变应性鼻炎患者进行鼻腔神经部分切断术与下鼻甲粘骨膜下血管神经离断术。所有病例随访12个月，评价其临床效果。结果：10例临床症状消失，体征明显改善；7例临床症状明显缓解，体征改善；1例无效。总有效率94．4％。结论：鼻腔神经部分切断和下鼻甲粘骨膜下血管神经离断术治疗常年性变应性鼻炎效果显著。     

等离子低温消融下鼻甲治疗常年性变应性鼻炎

目的：观察低温消融等离子体手术系统在治疗常年性变应性鼻炎中的作用。方法：鼻腔表面麻醉和下鼻甲黏膜下浸润麻醉后,应用鼻内镜对35例常年性变应性鼻炎患者的下鼻甲进行打孔消融治疗。结果：随访6个月以上,总有效率为94．3％(33／35),显效率为85．7％(30／35)。结论：等离子低温消融下鼻甲治疗常年性变应性鼻炎近期效果良好,操作简单,安全可靠,有较好的临床应用价值。     

鼻内镜下鼻窦手术中对异常中鼻甲的处理

目的探讨鼻内镜下鼻窦手术中对异常中鼻甲处理后尽可能给予保留的可行性和必要性。方法对36例伴有中鼻甲异常的慢性鼻窦炎患者,在行FESS时,根据不同中鼻甲异常(息肉样变、肥大、气化、外移或反折),分别给予相关手术处理,并尽可能地保留中鼻甲原解剖结构。结果全部患者术后经半年以上的随访,治愈33例(91.7%),好转3例(8.3%);患者主观感觉通气满意34例(94.4%),明显改善2例(5.6%);中鼻甲与中隔粘连2例(5.6%);中鼻甲形态良好。结论对伴有中鼻甲异常的慢性鼻窦炎患者,在行FESS中对异常中鼻甲进行恰当处理并尽可能保留其原解剖结构,对术后改善症状、减少中鼻甲与鼻腔外侧壁粘连、提高治愈率有重要临床意义,且手术操作简单。     

鼻腔结构正常化手术治疗鼻腔结构异常的变应性鼻炎68例

目的探讨鼻腔结构正常化手术治疗鼻腔结构异常的变应性鼻炎的临床意义。方法对68例伴有鼻腔结构异常的变应性鼻炎患者进行鼻腔结构正常化手术,参照我国兰州标准（2004年）对术前、术后症状和体征进行评分,评定效果。结果术后1年随访,总有效率88.3%。结论伴有鼻腔结构异常的变应性鼻炎患者,治疗应首选手术使之结构正常化,有利于减轻症状和体征。     

组织病理学评价下鼻甲部分切除术的适应证

手术治疗鼻甲粘膜肥厚引起的鼻腔通气功能障碍还存在争议。为了分析鼻腔阻塞原因,从病理学角度论证下鼻甲手术适应证。选择61例手术患者,分为血管运动性鼻炎、常年性变应性鼻炎、鼻中隔偏曲下鼻甲代偿性肥大三组。术中取活检,用图像分析系统评估单个血管的平均横截面积和血管数量,按平方像素计算。结果发现:血管运动性鼻炎组平均血管横截面积最大,与     

手术治疗常年性变应性鼻炎的方法及效果

目的探讨鼻腔综合手术治疗常年性变应性鼻炎的效果.方法鼻中隔黏膜下分离,并在软骨膜面划痕,切除下鼻甲的肥大部分,保留鼻中隔及下鼻甲部分黏膜于表面划痕.结果118例临床症状、体征消失,88例体征消失症状明显改善,10例无效,总有效率为95.3%.结论鼻腔综合手术治疗常年性变应性鼻炎效果肯定.     

Prevalence and risk factors for perennial allergic rhinitis in Korea: results of a nationwide survey

A nationwide survey on the prevalence and risk factors for perennial allergic rhinitis in Korea was conducted by means of physical examination by otolaryngologists from July to October 1991. The total number of subjects examined was 9069 and they were drawn from 2899 households in 60 different districts throughout the country. The overall prevalence of perennial allergic rhinitis was 1.14%. For the evaluation of risk factors for perennial allergic rhinitis, a case-control analysis was carried out. The prevalence was influenced by age and urban or rural province. Risk factors such as current urban residence, urban birth place, overcrowding, higher educational attainment, nasal septal deformity and chronic sinusitis with nasal polyposis, indicated an increased risk of perennial allergic rhinitis. Other factors such as smoking and personal factors showed little influence on prevalence.     

变应性因素及变应性鼻炎与慢性鼻-鼻窦炎鼻息肉的相关性探讨

目的：探讨变应性因素及变应性鼻炎（AR）与慢性鼻-鼻窦炎鼻息肉的临床相关性。方法：将200例研究对象分为A、B组,A组诊断为AR（110例）,B组诊断为慢性鼻-鼻窦炎鼻息肉（90例）,通过欧蒙印迹法定量检测血清sIgE浓度并观察慢性鼻-鼻窦炎鼻息肉手术治疗后的复发率、AR并发慢性鼻-鼻窦炎鼻息肉的发生率。结果：A组sIgE总阳性率为89.09%,B组sIgE总阳性率为74.44%。B组中sIgE阳性者术后复发率为58.21%,sIgE阴性者术后复发率为8.70%。A组41例（37.27%）并发慢性鼻-鼻窦炎鼻息肉,血清sIgE阳性率为97.56%;69例（62.73%）未并发慢性鼻-鼻窦炎鼻息肉,血清sIgE阳性率为79.71%;组内slgE阳性率比较差异有统计学意义（χ2=6.96,P〈0.01）。结论：变应性因素及AR与慢性鼻-鼻窦炎鼻息肉的发生有一定的相关性,提示避免接触变应原、合理治疗AR能够有效控制慢性鼻-鼻窦炎鼻息肉的复发率。     

Study of allergic fungal sinusitis in 40 surgical cases of chronic paranasal sinusitis

Allergic fungal sinusitis is chronic and paranasal, related to fungal allergy. Many papers on allergic fungal sinusitis have been reported in the United State, and the incidence is 5% to 10% among patients with chronic paranasal sinusitis. Although cases of allergic fungal sinusitis have been reported in Japan, the incidence is unclear. We studied allergic fungal sinusitis in 40 consecutive patients--26 men and 14 women--undergoing endoscopic sinus surgery at Keiyukai Sapporo Hospital December 2000 to July 2001. We checked for allergic rhinitis and asthma, a history of surgery for nasal polyps and chronic sinusitis, the presence of nasal polyps, grading of sinusitis via computed tomography, nonspecific IgE and allergen-specific IgE for fungi in serum, eosinophilia in nasal smears, paranasal eosinophilic mucin, and histology and fungal culture of paranasal sinus mucus. None had typical allergic fungal sinusitis, but 1 had eosinophilic paranasal mucin, high IgE, and false-positive IgE for fungi. We studied clinical data and histology of fungi and paranasal mucosa in 9 cases with fungal maxillary sinusitis, but none had allergy or eosinophilic mucin. This suggested that few patients with allergic fungal sinusitis exist among those with chronic paranasal sinusitis.     

Balanced physiological saline in the treatment of chronic rhinitis

The effects of a special balanced physiological saline on nasal symptoms of 93 patients with chronic rhinitis were studied. The main diagnoses of the patients were allergic rhinitis, atrophic rhinitis and ozaena, rhinitis sicca, chronic sinusitis, nasal polyposis and postoperative condition after nasal surgery. The tested solution was administered by a simple metered dose pump. 85 (91%) of the patients reported beneficial effects of the tested solution on nasal symptoms. In addition, 22 (71%) of those patients who used continuous anti-allergic medication, mainly intranasal steroids, reported that the tested solution improved the efficacy of their ordinary drug. So the tested solution proved to be beneficial in humidifying atrophic or otherwise dry mucosa, douching crusty nose and as adjuvant therapy in the treatment of allergic rhinitis.     

变应性因素对鼻内镜手术疗效的影响

目的：探讨变应性因素对慢性鼻窦炎伴鼻息肉患者行鼻窦内窥镜手术疗效的影响。方法对我院2011～2012年入院手术的II型慢性鼻窦炎伴鼻息肉患者,术前根据其是否伴有变应性鼻炎症状和体征、是否伴有过敏性疾病史及支气管哮喘病史、术前鼻腔分泌物涂片嗜酸粒细胞检查、变应原皮肤试验、血清特异性IgE检查、过敏性鼻炎,筛选出伴有变应性因素的慢性鼻窦炎伴鼻息肉患者为试验组。选择同期无变应性因素的单纯慢性鼻窦炎伴鼻息肉患者作为对照组。比较两组患者手术后疗效,并同时比较各种变应性因素对手术疗效的影响。结果伴有变应性因素的慢性鼻窦炎伴鼻息肉患者,手术疗效为80.95%（136/168）,同期单纯慢性鼻窦炎伴鼻息肉患者,手术疗效为91.75%（189/206）,两组间差异有显著性（P〈0.01）。在各种变应性因素中,伴有变应性鼻炎症状和体征、嗜酸粒细胞阳性、变应原皮肤试验阳性、血清特异性IgE、过敏性鼻炎的慢性鼻窦炎伴鼻息肉患者,与无变应性因素的慢性鼻窦炎伴鼻息肉患者比较,差异均有显著性（P〈0.05）,伴有过敏性疾病史及伴支气管哮喘病史患者与无变应性因素的慢性鼻窦炎伴鼻息肉患者比较,差异无显著性（P〉0.05）。结论变应性因素与鼻窦内窥镜手术疗效密切相关,是术后复发的重要因素。对慢性鼻窦炎伴鼻息肉患者行鼻窦内窥镜手术时,必须加强围手术期抗变应性治疗。     

鼻腔冲洗在儿童鼻炎及鼻窦炎治疗中的应用发展

儿童鼻-鼻窦炎在儿科是一种常见疾病,有其自身特点,除进行药物治疗,同时鼻腔冲洗也是一种保持鼻腔清洁、减轻鼻黏膜炎症反应的有效方法,可以广泛应用于各种儿童鼻腔、鼻窦炎性疾病,包括急性和慢性鼻窦炎、变应性及非变应性鼻炎、非特定性鼻腔症状等。儿童鼻腔冲洗液的选择、鼻冲洗装置的选择有其区别于成人的特点。由于该方法临床运用有效,操作简便,是一种为儿童易于接受的治疗方法,具有良好的安全性和耐受性。本文就鼻腔冲洗在儿童鼻炎及鼻-鼻窦炎治疗中的应用发展做一综述。     

Nasal mastocytosis

The treatment of obstructed nose due to removable lesions such as adenoidal hypertrophy, nasal polyps, tumors or deviation of the septum is surgical. In the non-surgical obstructed nose the establishment of the proper diagnosis in order to institute proper therapy is obvious. The allergic nose is treatable in most instances with antihistamines, decongestants, and, appropriately, by desensitization. There is a considerable body of patients with non-allergic perennial rhinitis who have no surgical obstruction, and who have been treated, usually for years, with the usual modes appropriate for the allergic nose. The results universally are poor. Nasal biopsies have been used to show a marked difference of infiltration of the mast cell in the submucosa of patients with perennial rhinitis who have neither obstruction due to surgically treatable conditions or due to allergic rhinitis. It is postulated that the mast cells infiltrate the nasal mucosa in response to factors yet to be determined. The mast cell contains chemical mediators which when released into the nasal tissue cause the symptoms of perennial rhinitis. The diagnosis cannot be made by direct visualization or even by nasal mucus smears but only made by biopsy. Surgery and allergy management usually fail in these patients, and usually they respond only to an honest explanation of the condition and short term steroid therapy.     

鼻咽癌放疗后鼻并发症Logistic回归分析

目的：探讨鼻咽癌患者放疗后发生远期鼻并发症的相关因素。方法：随访观察131例鼻咽癌患者放疗后的鼻疾病，将可能影响并发症发生的有关因素通过Logistic回归模型分析。结果：放疗后最常出现的并发症是慢性化脓性鼻窦炎(116／131)，选入回归方程的因素有T分期、鼻前野照射；其次是鼻粘连(33／131)，选人的因素有鼻咽腔外照射总剂量、鼻咽腔内照射、药物性鼻炎；萎缩性鼻炎少见(9／131)，选入的因素有同时期化疗、药物性鼻炎。结论：肿瘤的T分期、鼻前野照射与放疗后鼻窦炎的发生有关；鼻咽腔外照射剂量越高，或加做鼻咽腔内照射以及长期过量使用鼻血管收缩剂，容易导致鼻粘连；使用化疗药物及鼻血管收缩剂，可能是影响萎缩性鼻炎发生的因素之一。