CAJ | 학술논문

目的观察内镜下后鼻孔成形术治疗先天性后鼻孔闭锁的疗效.方法回顾性分析首都医科大学附属北京儿童医院2006年1月至2012年9月间,经电子鼻咽镜检查及鼻窦CT扫描确诊为先天性后鼻孔闭锁的15例患儿的临床资料,年龄4～6岁;其中男7例、女8例;单侧闭锁6例,双侧闭锁9例;10例(16侧)为膜性闭锁,2例(4侧)为混合型闭锁,3例(4侧)为骨性闭锁.全部患儿均在全麻内镜下行后鼻孔成形术,成形扩大后鼻孔后放置支撑管.术后保留鼻腔支撑管3个月,常规护理下维持支撑管通畅,术后3个月拔除支撑管后坚持生理海水鼻腔冲洗,交替内镜下观察及换药.结果随访至术后1年,15例患儿复查电子鼻咽镜,见后鼻孔无挛缩表现,治疗有效率达100％,无再手术病例.结论鼻内镜下后鼻孔成形术治疗儿童先天性后鼻孔闭锁疗效肯定,安全性高.
목적 관찰내경하후비공성형술치료선천성후비공폐쇄적료효.방법 회고성분석수도의과대학부속북경인동의원2006년1월지2012년9월간,경전자비인경검사급비두CT소묘학진위선천성후비공폐쇄적15례환인적림상자료,년령4～6세;기중남7례、녀8례;단측폐쇄6례,쌍측폐쇄9례;10례(16측)위막성폐쇄,2례(4측)위혼합형폐쇄,3례(4측)위골성폐쇄.전부환인균재전마내경하행후비공성형술,성형확대후비공후방치지탱관.술후보류비강지탱관3개월,상규호리하유지지탱관통창,술후3개월발제지탱관후견지생리해수비강충세,교체내경하관찰급환약.결과 수방지술후1년,15례환인복사전자비인경,견후비공무련축표현,치료유효솔체100％,무재수술병례.결론 비내경하후비공성형술치료인동선천성후비공폐쇄료효긍정,안전성고.
Objective To observe the effect of transnasal endoscopic choanal plasty for repairing congenital choanal atresia.Method A retrospective analysis of 15 patients with choanal atresia in Beijing Children's Hospital from January 2006 to September 2012 was made.All the 15 patients accepted electronic nasopharyngoscope examination and CT scanning of the paranasl sinus.The age was between 4 years old and 6 years old.Seven of them were male and 8 were female.Six cases were unilateral atresia,9 were bilateral atresia.Ten cases (16 sides) were membranous atresia,2 cases (4 sides) were mixed type atresia and 3 cases (4 sides) were bony atresia.All the patients accepted transnasal endoscopic choanal plasty.A tube was placed in order to support the enlarged nostrils.The nasal tube should be retained for 3 months and kept patency by routine care.Three months after operation,the tube could be removed.The patients were told to do physiological saline nasal irrigation and receive regular review by transnasal endoscopy.Result The patients were followed up for 1 year postoperatively by electronic nasopharyngoscope examination.There was no failure case in all the 15 patients.The total effective rate was 100％.Conclusion Transnasal endoscopic choanal plasty had better efficacy and safety in the treatment of congenital choanal atresia.