真菌性上颌窦炎手术径路的选 择简

目的 探讨不同手术径路对真菌性上颌窦炎的临床疗效.方法 选择广西壮族自治区钦州市第一人民医院2009年1月～2012年3月真菌性上颌窦炎患者64例为研究对象,按就诊顺序随机分为观察组和对照组,每组各32例,观察组给予鼻内镜联合尖牙窝小视窗双径路手术治疗,对照组给予单纯鼻内镜手术治疗,评价并比较两组患者疗效和主观量表评分.结果 观察组有效率为96.86％,明显高于对照组（75.00％）,两组比较,差异有高度统计意义（P=0.000）;术后1个月两组患者症状和鼻内镜检查结果差异有统计学意义（x2=6.251、8.523,P＜0.05）,观察组效果优于对照;术后3个月观察组症状改善情况优于对照组（x2=5.842,P＜0.05）,两组鼻内镜检查结果相比较,差异无统计学意义（x2=2.012,P＞0.05）;观察组和对照组术前主观症状分别为（5.12±1.21）、（5.31±1.03）分,两组相比差异无统计学意义（P＞0.05）,术后观察组症状评分分别为（0.34±0.16）分,低于对照组（0.94±0.14）分],差异有统计学意义（P＜0.05）;两组手术前后得分比较,差异均有高度统计学意义（均P＜ 0.01）.观察组复发率为3.13％,明显低于对照组（12.5％）,两组比较,差异有高度统计学意义（x2=8.205,P=0.000）.结论 真菌性上颌窦炎治疗原则为彻底清除真菌团块,鼻内镜联合尖牙窝小视窗双径路手术可明显改善患者主观症状,效果优于单纯鼻内镜手术,临床应重视其应用.

The selection of different surgery path in fungal maxillary sinusitis

Objective To investigate the clinical curative effect of the different surgery path on fungal maxillary si nusitis. Methods 64 patients with of fungal maxillary sinusitis in the First People＇s Hospital of Qinzhou City in Guangxi Zhuang Autonomous Region from January 2009 to March 2012 were selected and were randomly divided into observation group and control group according to the attendance order. Patients in the observation group were given double path surgery within nasal endoscopy combined fangs nest small windows and patients in control group were giv- en the nasal endoscope, curative effect and subjective symptom score evaluation of two groups were evaluated and compared. Results Effective rate of observation group was 96.86%, was higher than that of control group （75.00%）, the difference of two was high statistically significant （P = 0.000）. One month after treatment, the symptoms and results of nasal endoscopy of patients in two groups had statistic difference （X2=6.251, 8.523, P 〈 0.05）, the observation group was better than the control; three months after treatment the symptoms of observation group was better than that in the control group （X2=5.842, P 〈 0.05）, the results of nasal endoscopy in the two groups was found had no statistically signif icant difference （X2=2.012, P 〉 0.05）. Preoperative subjective symptoms of two groups were （5.12±1.21）, （5.31±1.03） scores respectively, there was no statistically significant difference （P 〉 0.05）; postoperative symptoms of observation groups was （0.34±0.16） scores, was lower than that of the control group （0.94±0.14） scores], both two groups compared with the preoperative, the differences were high statistically significant （all P 〈 0.01）; the recurrence rate in the observation group was 3.13%, was lower than that of the control group （12.5%）, the difference was high statistically significant （X2= 8.205, P = 0.000）. Conclusion The principle of fungal maxillary sinusitis treatment is eradicate mould briquette, dou- ble t）ath surgery within nasal endoscopy combined fan±s nest small windows can imnrove the subiective svmDtoms ofthe patients significantly, and the effect is better than that of simple nasal endoscopic surgery, should pay at tention to its clinical application.