鼻内镜下真菌性上颌窦炎的治疗体会

目的 探讨鼻内镜下中、下鼻道双径路与鼻内镜下中鼻道两种手术方式治疗真菌性上颌窦炎的疗效. 方法 40例真菌性上颌窦炎患者行鼻内镜下中、下鼻道上颌窦联合开窗术治疗(A组),53例采用鼻内镜下中鼻道开窗术治疗(B组).术后随访1~2年,定期行鼻窦冲洗及鼻内镜复查.根据1997年海口标准评定手术疗效.结果 A组治愈36例(90%),好转4例(10%),无效0例,有效率为100%;B组治愈45例(84.9%),好转1例(1.9%),无效及复发7例(13.2%),有效率为86.8%.两组有效率差异有统计学意义(χ²=5.713, P=0.018). 结论 鼻内镜下鼻窦术治疗真菌性上颌窦炎有效,可先行中鼻道开窗术,对真菌球不能彻底清除者,加用下鼻道开窗术治疗,可以达到理想的效果.

Endoscopic surgery for treating fungal maxillary sinusitis

Objective To explore the treatment effect of middle and inferior antrostomies in the endoscopic and simple endoscopic sins surgery for fungus maxillary sinusitis. Methods 40 cases were treated with endoscopic surgery middle plus inferior antrostomies (A group), and 53 cases were treated with nasal endoscopic fenestration of middle meatus (B group). Based on the Haikou standard in accordance with 1997, the efficacy of the two groups was assessed. Results During a post-operative follow-up of 1 to 2 years, 36 cases were cured (90%) and 4 cases were improved (10%) in group A, while 45 cases were cured(84.9%), 1 case was improved(1.9%) and 7 cases were relapsed or had no effect. The difference was significant between the two groups (χ²=5.713, P=0.018). Conclusion Nasal endoscopic operation for fungus ball maxillary sinusitis is effective.