功能性内窥镜鼻窦手术前筛动脉血管 CT成像分析

目的：利用256排CT进行筛前、筛后动脉血管成像,为功能性内窥镜鼻窦手术（ functional endoscopic sinus surger-y, FESS）提供术前参考。方法对40例鼻炎和/或鼻窦炎患者进行256排CT头部血管成像,在工作站进行二维和三维重建分析,辨别筛前动脉和筛后动脉,统计其出处（眼动脉O1-O3段）,测量筛前动脉与前鼻棘距离及其连线与鼻底的夹角。结果辨别出40例患者筛前动脉75支,辨别出24例患者筛后动脉39支;其中,有70支筛前动脉起自眼动脉O3段,占93．3％,5支起自眼动脉弯,占6．7％。有22支筛后动脉起自眼动脉弯,占56．4％,10支筛后动脉起自O2段,占25．6％,7支筛后动脉起自O3段,占17.9％;表现为同一患者双侧不一定对称;测量筛前动脉与前鼻棘距离（85．1±3．1） mm,与鼻底夹角为（49．3±0.8）°。结论用256排CT进行筛前、筛后动脉血管成像,辨识率较高,相关数据测量有助于术前了解筛动脉情况,有利于预防FESS大出血。     

复方盐酸萘甲唑啉鼻用喷剂治疗慢性单纯性鼻炎的临床观察

目的 观察复方盐酸萘甲唑啉鼻用喷剂治疗慢性单纯性鼻炎的疗效及不良反应.方法 500例慢性单纯性鼻炎患者连续使用复方盐酸萘甲唑啉鼻用喷剂4周,200例对照组患者使用生理盐水喷鼻,使用视觉模拟量表(visual analoguescale,VAS)症状量化评估治疗效果,比较2组患者的疗效.结果 使用复方盐酸萘甲唑啉鼻用喷剂...     

少见鼻中隔脓肿二例

鼻中隔脓肿多见于鼻外伤或鼻中隔手术,2006-2007年我科诊治2例病因不典型的少见鼻中隔脓肿患者,现报告如下.     

声带息肉伴真菌感染1例

患者,男,43岁,因反复声音嘶哑7年余于2009年6月22日来我院就诊。患者近7年来无明显诱因反复出现声音嘶哑,未给予重视,本次发病为劳累后声嘶加重,无咽痛、咳嗽、咳痰、鼻塞等上呼吸道感染症状。既往体健,否认有肿瘤、结核、糖尿病、肝肾功能不全等慢性疾病史。电子喉镜检查     

微波热凝治疗Little''s区鼻出血的疗效观察

目的：观察和探讨微波热凝治疗Little＇s区鼻出血的疗效。方法：对95例Little＇s区鼻出血患者给予局部微波热凝治疗,随访观察3--4个月。结果：微波热凝治疗Little＇s区鼻出血的治愈率为90．5％,有效率为100％。仅1例于治疗后2个月黏膜创面已完全愈合时发生鼻中隔脓肿,可能与本治疗有关,其余患者未发生鼻腔黏连和鼻中隔穿孔等并发症。结论：微波热凝治疗Little＇s区鼻出血具有疗效好、操作简便、痛苦小、并发症少等特点,值得临床推广应用。     

鼻内镜下曲安奈德冲洗咽鼓管治疗慢性分泌性中耳炎

目的探讨鼻内镜下曲安奈德冲洗咽鼓管治疗慢性分泌性中耳炎的疗效。方法 42例慢性分泌性中耳炎患者分为2组,治疗组22例29耳,鼻内镜下用曲安奈德冲洗咽鼓管;对照组20例24耳,鼓室内注射地塞米松、α-糜蛋白酶,比较两组疗效。结果治疗组治愈22耳,占75.86%(22/29),好转3耳,占10.34(3/29)%,总有效率86.20%;对照组治愈17耳,占70.83(17/24)%,好转3耳,占12.50%(3/24),总有效率83.33%,两组总有效率无明显差异(P>0.05),但治疗组首次治疗有效率79.31%(23/29)高于对照组首次治疗有效率58.33%(14/24)。结论鼻内镜下曲安奈德冲洗咽鼓管治疗慢性分泌性中耳炎疗效与传统鼓膜穿刺给药法疗效相近,但首次治疗有效率高,为慢性分泌性中耳炎的治疗提供了一种新选择。     

远海长航舰艇人员阻塞性睡眠呼吸暂停低通气综合征问卷调查

目的 对远海长航舰艇人员阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apneahypopnea syndrome,OSAHS)情况进行问卷调查,为进一步进行相关研究提供参考.方法 在"和谐使命-2010"卫勤演练期间,对参与亚丁湾护航的2艘舰艇部分官兵进行OSAHS问卷调查.其中A组某舰官兵114名.出航时间3个月;B组为某舰官兵139名.出航时间6个月.对A、B组出航前后睡眠情况进行统计,并对2组的睡眠时间和OSAHS情况进行比较.结果 B组每日的睡眠时间较A组缩短.A组有OSAHS倾向的19人,发生率16.7%;B组有34人,发生率24.5%,B组高于A组.2组中共有155人(61.3%)认为出航后睡眠情况较出航前差.结论 远海长航舰艇人员OSAHS倾向的发生率较高,随着出航时间的延长睡眠情况逐渐变差,OSAHS倾向的发生率增高.提示远海长航舰艇人员OSAHS情况值得进一步研究.

Abstract：

Objective To perform a questionnaire on the obstructive sleep apnea-hypopnea syndrome (OSAHS) among the prolonged ocean-going shipboard personnel, so as to provide reference data for further study of this kind. Methods During the medical support exercise of " Operation Harmony-2010", a questionnaire on OSAS was performed in the officers and men of the 2 naval vessels involved in the escort mission in the Gulf of Aden. Participating in the questionnaire were officers and men of a certain naval vessels belonging to group A in a prolonged deployment at sea for a duration of 3 months. The other 139 officers and men of the other naval vessels belonging to group B were deployed there for a duration of 6 months. Statistical analyses were made on the changes in the sleep status of the 2 groups both before and after deployment. Then, the sleep time and OSAHS were compared and analyzed between the 2 groups. Results Sleeping time each day for group B was shorter than that for group A. The number of people in group A who had a tendency of developing OSAHS was 19, with the incidence rate being 16. 1% , while 34 people in group B developed OSAHS, with the incidence rate being 24.5%. The incidence rate of group B was obviously higher than that of group A. There were altogether 155 people (61. 3%) in the 2 groups, who thought their sleeping status after deployment became worse, when it was compared with that before deployment. Conclusions Prolonged oceangoing shipboard personnel had a higher incidence rate of OSAHS. With the prolonging of deployment, sleeping among the deployed personnel would become worse and the tendency of developing OSAHS would become higher. This indicated that OSAHS occurring among the prolonged ocean-going shipboard personnel was a medical problem worth further close study.     

鼻中隔偏曲矫正术治疗变态反应性鼻炎106例疗效观察

变态反应性鼻炎(allergic rhinitis,AR)是耳鼻咽喉头颈外科的常见病之一,且随着工业的发展和生活环境的改变,变态反应性鼻炎的发病率近年来有增高的趋势,已成为亟待解决的全球性健康问题,严重影响了患者的生活质量,其发病机制至今尚不明确。目前变应性鼻炎常规以药物保守治疗为主,但不良反应大、易反复,尤其是一部分伴有鼻中隔偏     

渡海训练溺水致分泌性中耳炎一例

临床资料:患者,男性,21岁,某部战士,在渡海游泳训练时溺水,2h后因双耳胀痛、听力下降入本院就诊.专科检查:电子显微耳镜示双侧鼓膜完整,颜色正常,透过鼓膜见鼓室内透亮的水平形液平面,随头部活动晃动.纯音听阈测试示双耳气导25 dB左右,骨导10 dB左右,提示轻度传导性聋,诊断:双侧鼓室积水.给予呋麻滴鼻液滴鼻3次/d,口服琥乙红霉素250 mg,3次/d.3d后患者来院复查,诉双耳闷、听力仍不好,电子显微耳镜示:双侧鼓膜内陷,颜色淡黄,透过鼓膜见鼓室内积液,可见气泡,积液活动度差.     

远海长航舰艇人员阻塞性睡眠呼吸暂停低通气综合征问卷调查

目的 对远海长航舰艇人员阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apneahypopnea syndrome,OSAHS)情况进行问卷调查,为进一步进行相关研究提供参考.方法 在"和谐使命-2010"卫勤演练期间,对参与亚丁湾护航的2艘舰艇部分官兵进行OSAHS问卷调查.其中A组某舰官兵114名.出航时间3个月;B组为某舰官兵139名.出航时间6个月.对A、B组出航前后睡眠情况进行统计,并对2组的睡眠时间和OSAHS情况进行比较.结果 B组每日的睡眠时间较A组缩短.A组有OSAHS倾向的19人,发生率16.7%;B组有34人,发生率24.5%,B组高于A组.2组中共有155人(61.3%)认为出航后睡眠情况较出航前差.结论 远海长航舰艇人员OSAHS倾向的发生率较高,随着出航时间的延长睡眠情况逐渐变差,OSAHS倾向的发生率增高.提示远海长航舰艇人员OSAHS情况值得进一步研究.