鼻中隔矫正术对鼻窦手术疗效影响.docVIP

鼻中隔矫正术对鼻窦手术疗效影响[摘要]目的:探讨慢性鼻窦炎患者同期行鼻内镜下鼻窦开放及鼻中隔矫正术的术后疗效及术式可行性。方法:124例鼻内镜下鼻窦手术,其中51例患者同期行鼻中隔矫正术。结果:51例同期行鼻中隔矫正术者鼻窦开放良好,鼻中隔正中位,未发生粘连、鼻中隔穿孔等。结论:同期行鼻内镜下鼻窦开放及鼻中隔矫正术是一种安全可行的手术方式,具有并发症小、复发率低等优点。 [关健词]鼻中隔偏曲;鼻窦炎;外科手术;疗效 [中图分类号]R765.31 [文献标识码]A [文章编号]1008-6455(2010)06-0795-02 Observation on nasal septum surgery combined with nasal sinus surgery WANG Xun1,FAN Ju-feng2,WANG Ning-yu1 (1.Department of Otolaryngology-Head and Neck Surgery,2.Department of Plastic Surgery,Beijing Chaoyang Hospiatal of Capital Medical University,Beijing 100020,China) Abstract:ObjectiveTo observe the clinical effect of nasal septum surgery combined with nasal sinus surgery under nasal endoscope and to discuss the feasibility.MethodsFifty-one patients underwent nasal septum and nasal sinus operation and compared with patients underwent only simple nasal sinus operation.ResultsAll patients with nasal septum deviation were completed successfully corrected with satisfactory ventilation in both sides of nasal cavity. No perforation of nasal septum and no nasal cavity adhesion occurred in all cases.ConclusionNasal septum surgery combined with nasal sinus surgery is a good technique for treatment of nasal sinusitis, and it can decrease the recurrence rate of nasal polyp and sinusitis and don’t increase the rate of complication occurring. Key words:nasal deviation;sinusitis;operative;curative effect 慢性鼻窦炎是耳鼻咽喉科的多发病,而鼻中隔偏曲是慢性鼻窦炎的病因之一[1]。在行鼻内镜下鼻窦开放手术中,同期行鼻中隔矫正术,可以使鼻腔解剖结构正常化,对防止术后并发症及复发有重要意义。 我科于2003年6月～2004年6月间施行鼻内镜下鼻窦手术124例,合并鼻中隔偏曲79例。其中51例患者同期行鼻中隔矫正术。发现其临床疗效优于未行鼻中隔矫正者。现报道如下。 1资料和方法 1.1一般资料:本组患者79例,男49例,女30例;年龄18～66岁,平均45岁;病程1～23年,平均5年。79例患者均有鼻中隔偏曲,其中双侧鼻窦炎45例,单侧鼻窦炎20例,真菌性鼻窦炎12例。鼻腔鼻窦内翻性乳头状瘤2例。鼻窦炎中伴发鼻息肉36例。临床表现为鼻塞、流脓涕、嗅觉减退。部分患者有头痛,鼻部发胀感。所有患者均行前鼻镜、鼻内镜及鼻窦CT检查。 1.2手术方法:全部病例均采用插管全麻下手术。51例患者均同期行鼻中隔矫正术。28例未行鼻中隔矫正患者,其中有19例行下鼻甲骨折外移,9例单纯行鼻窦开放术。 1.3术后处理:术后48h抽出鼻腔填塞物。1周后开始清理鼻腔结痂,并用雷诺考特喷鼻剂,连用3月。鼻腔换药1周一次,连续4次后改为2周一次,直至伤口愈合。 2结果 同期行鼻中隔矫正术的51例患者在45～50天内观察到:鼻窦开放良好,窦腔上皮化,鼻中隔正中位,未发生粘连、鼻