中国中西医结合耳鼻咽喉科杂志
中國中西醫結閤耳鼻嚥喉科雜誌
중국중서의결합이비인후과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2013年
5期
373-376
,共4页
怀德%戴俊%徐敏%张学文%严济鸣%张亚龙%王建武%张军%周晓健%金同爱%殷敏%程雷
懷德%戴俊%徐敏%張學文%嚴濟鳴%張亞龍%王建武%張軍%週曉健%金同愛%慇敏%程雷
부덕%대준%서민%장학문%엄제명%장아룡%왕건무%장군%주효건%금동애%은민%정뢰
难治性鼻-鼻窦炎%修正性鼻内镜手术%中鼻甲切除术
難治性鼻-鼻竇炎%脩正性鼻內鏡手術%中鼻甲切除術
난치성비-비두염%수정성비내경수술%중비갑절제술
Refractory rhinosinusitis%Revision endoscopic sinus surgery%Middle turbinectomy
目的：探讨修正性鼻内镜手术联合中鼻甲切除术综合治疗难治性鼻-鼻窦炎的手术效果及应用价值。方法35例难治性鼻-鼻窦炎经CT检查、鼻内窥镜检查、局部用药等规范术前准备，行改良鼻丘径路额窦开放为主修正手术加中鼻甲全部或部分切除，术后凭鼻内镜保健手册进行定期复查，规范随访。26例合并鼻中隔偏曲者其中16例行内镜下传统矫正切除，10例行局限性矫正切除；15例合并变应性鼻炎者对下鼻甲前端、中鼻甲对应鼻中隔等部位黏膜电凝。结果35例患者门诊内镜随诊3-6月以上，治愈11例（31.4%），黏膜完全上皮化；好转18例（51.4%），黏膜可以上皮化，但变应性鼻炎发作时，术腔黏膜水肿，经局部处理及药物治疗后可恢复上皮化；无效6例（17.2%）。总有效率82.8%，6例无效均为合并变应性鼻炎及哮喘患者。结论修正性鼻内镜手术联合中鼻甲切除术综合治疗难治性鼻-鼻窦炎，疗效较为确切，值得临床推广。
目的：探討脩正性鼻內鏡手術聯閤中鼻甲切除術綜閤治療難治性鼻-鼻竇炎的手術效果及應用價值。方法35例難治性鼻-鼻竇炎經CT檢查、鼻內窺鏡檢查、跼部用藥等規範術前準備，行改良鼻丘徑路額竇開放為主脩正手術加中鼻甲全部或部分切除，術後憑鼻內鏡保健手冊進行定期複查，規範隨訪。26例閤併鼻中隔偏麯者其中16例行內鏡下傳統矯正切除，10例行跼限性矯正切除；15例閤併變應性鼻炎者對下鼻甲前耑、中鼻甲對應鼻中隔等部位黏膜電凝。結果35例患者門診內鏡隨診3-6月以上，治愈11例（31.4%），黏膜完全上皮化；好轉18例（51.4%），黏膜可以上皮化，但變應性鼻炎髮作時，術腔黏膜水腫，經跼部處理及藥物治療後可恢複上皮化；無效6例（17.2%）。總有效率82.8%，6例無效均為閤併變應性鼻炎及哮喘患者。結論脩正性鼻內鏡手術聯閤中鼻甲切除術綜閤治療難治性鼻-鼻竇炎，療效較為確切，值得臨床推廣。
목적：탐토수정성비내경수술연합중비갑절제술종합치료난치성비-비두염적수술효과급응용개치。방법35례난치성비-비두염경CT검사、비내규경검사、국부용약등규범술전준비，행개량비구경로액두개방위주수정수술가중비갑전부혹부분절제，술후빙비내경보건수책진행정기복사，규범수방。26례합병비중격편곡자기중16례행내경하전통교정절제，10례행국한성교정절제；15례합병변응성비염자대하비갑전단、중비갑대응비중격등부위점막전응。결과35례환자문진내경수진3-6월이상，치유11례（31.4%），점막완전상피화；호전18례（51.4%），점막가이상피화，단변응성비염발작시，술강점막수종，경국부처리급약물치료후가회복상피화；무효6례（17.2%）。총유효솔82.8%，6례무효균위합병변응성비염급효천환자。결론수정성비내경수술연합중비갑절제술종합치료난치성비-비두염，료효교위학절，치득림상추엄。
Objective o investigate the surgery effect and used value of revision endoscopic sinus surgery coalition middle turbinectomy comprehensive used in treating refractory rhinosinusitis.Methods 5 patients with refractory rhinosinusitis conducting CT scan,nasal endoscopy and local drug application,proceeding improved frontal sinus pathways agger based correction surgery plus all or part of the middle turbinate resection,postoperative managing and follow-up researching by virtue of the endoscopic manual.26 patients with deviation of nasal septum,16 among which using traditional correction routine endoscopic resection and 10 patients underwent resection of the limitations of correction; 15 patients accompany with allergic rhinitis were right inferior turbinate front of the nasal septum and other parts of the middle turbinate mucosa corresponding coagulation.Results 35 patients were followed up for 3~6 months or more with outpatient endoscopy,cured 11 cases (31.4%),mucosal epithelium completely;improvement in 18 cases (51.4%),mucosal epithelium may be,because the surgery cavity mucosal will edema on the onset of allergic rhinitis,but after local treatment and drug treatment the epithelium will rapidly restored; 6 cases of no avail (17.2%). The total efficiency of the method was 82.8%.6 ineffective cases were all with allergic rhinitis or asthma.Conclusion Revision endoscopic sinus surgery coalition middle middle turbinectomy comprehensive in treating refractory rhinosinusitis,the surgery effect is marked and worthiness popularizes application.
