鼻腔鼻窦侵袭型真菌病2例报道

目的:探讨鼻腔鼻窦侵袭型真菌病临床特点、诊断标准、治疗原则。方法通过2例收治的侵袭性真菌性鼻窦炎总结其病史、临床表现、影象学特征.复习相关文献。结果1.病因:广谱抗生素不正确、不规范的应用造成菌群失调,糖尿病、血液病、恶性肿瘤、器官移植后长期应用免疫抑制荆以及各种介入性诊治手段的开展与应用都为真菌致病创造了条件,主要的致病菌为曲霉菌、毛霉菌、念珠菌等。2.根据临床表现可分为三型:慢性侵袭型、急性爆发型、肉芽肿性侵袭型。3.诊断:本病的诊断不仅要依据其病史、临床表现、CT和MRI,还主要依靠鼻腔分泌物涂片及病理检查结果进行综合分析。4.治疗:鼻腔鼻窦侵袭型真菌病确诊后的治疗主要是根治性清创,然后最好能依据药物敏感试验,选择合适的抗真菌药物。结论鼻腔鼻窦侵袭型真菌病临床少见,病情凶险,预后差。手术后全身和局部应用抗真菌药物,延长患者的生存期,提高生存质量。

Invasive Fungal Rhinosinusitis two Cases with Literature Review

Objective To discuss the clinical presentation .diagnostic criterion and treatment principle of acute fulminant invasive fungal rhinosinusitis. Methods Two cases of acute fulminant invasive fungal rhinosinusitis were analyzed with elevant literature review. Results 1. Cause of a disease: That broad spectrum antibiotic is not correct application lead bacteria colony to be out of balance. The diabetes, blood sickness, malignant tumor, applicating immunity inhibitor all created the condition for the fungus pathogenesis. 2. May divide into three: chronic attack, acute e-ruption. granulation attack. 3. Diagnosis : The diagnosis not only needs to rest on its medical history, the clinical manifestation. CT and MRI, but also the main dependence nose cavity pathology. 4. Treatment: The disease treatment mainly is operation and chooses the appropriate anti- fungus medicine. Conclusion The nose cavity paranasal sinus attack fungus disease is rare, danger, easy death. After surgery , applies the anti- fungus medicine may lengthens patients lifetime and improves the survival quality.