非侵袭性真菌性鼻窦炎的诊疗方法及疗效分析

目的 探讨非侵袭性真菌性鼻窦炎的临床表现、诊断和手术疗效,旨在为诊断和治疗提供科学依据.方法 采用回顾性分析83例非侵袭性真菌性鼻窦炎患者的临床表现、鼻内镜检查和CT扫描的病变特征以及鼻内镜下手术治疗的效果.结果 83例患者均采用鼻内镜下手术治疗,术中及术后未出现并发症;所有患者术后均未服用抗真菌药物治疗,术后随诊3～12个月,76例经鼻内镜复查发现预后良好,提示鼻内镜治疗非侵袭性真菌性鼻窦炎疗效较好；在术后4个月和6个月各有7例复发,再次行鼻内镜手术治疗,随访未见复发.结论 鼻内镜检查和CT扫描对诊断有较高诊断价值,鼻内镜手术疗效确切,术后鼻内镜复查、鼻腔冲洗可有效预防疾病复发,术后是否采用抗真菌药物治疗尚待探讨.

Diagnosis and treatment of non-invasive fungal sinusitis and clinical efficacy

OBJECTIVE To investigate the clinical manifestation,diagnosis,and effect of nasal endoscopic surgery(NES) of non-invasive fungal sinusitis(NIFRS),aiming at providing scientific guideline for clinical diagnosis and treatment.METHODS Retrospective analysis was used to investigate the clinical diagnosis,treatment and effect of nasal endoscopic surgery(NES)and CT.RESULTS All of the 83 patients who underwent NES were without intraoperative and postoperative complications.None of the patients used antifungals.Follow-up for 3-12 months was performed after the surgery,the prognosis of 76 patients was good,which indicated that the clinical efficacy of NES in treatment of NIFRS was good;7 cases recurred in 4 and 6 months after the operation,and none recurred to date after the NES was performed once again.CONCLUSION NES and CT have good value in the diagnosis.NES had eutherapeutic effect;the postoperative nasal endoscopic check and nasal douche would be recommendable for preventing the relapse,whereas whether antifungal drugs can be used for treatment after the operation remains to be further studied.