变应性真菌性鼻窦炎的临床分析  

Clinical analysis on the allergic fungal rhinosinusitis

作　　者：邵辉[1] 王凤鸣[1] 董维刚[1] 

机构地区：[1]宁夏医科大学总医院耳鼻咽喉头颈外科,宁夏银川750004

出　　处：《宁夏医学杂志》2013年第3期248-250,共3页Ningxia Medical Journal

摘　　要：目的探讨变应性真菌性鼻窦炎(AFRS)的诊断及治疗方法。方法对20例AFRS患者术前常规进行鼻内镜检查、鼻窦CT检查、变应原皮内试验及术后组织病理学检查,均行鼻内镜手术,术前及术后配合抗生素、皮质类固醇激素和局部抗真菌药鼻腔冲洗治疗,术后随访6个月～1年。结果 20例AFRS患者内镜检查可见鼻腔单发或多发半透明息肉组织,真菌在内的1种以上变应原阳性;鼻窦CT多显示为病变鼻窦腔内周边为软组织影,中心呈斑片状或条索状高密度影;术后病检提示组织内较多嗜酸粒细胞浸润,可见真菌丝。经综合治疗后随访6个月～1年,15例术腔黏膜完全上皮化,4例复发,1例半年后失访。结论正确诊断变应性真菌性鼻窦炎是治疗的基础,而鼻内镜手术结合全身和(或)局部激素以及局部抗真菌药鼻腔冲洗是治疗变应性真菌性鼻窦炎的有效手段。Objective To explore the treatment and therapy method of the allergic fungal rhinosinusitis （AFRS）. Methods 20 patients with allergic fungal sinusitis were diagnosed by routine endoscopic procedure, paranasal sinus CT scan, skin prick test and his- topathological examination. All patients received functional endoscopic sinus surgery, and followed up 6 to 12 months strictly. Results 20patients were found the nasal polyp interoperation by endoscopic detection. More than one kind allergen was found in all pa- tients except fungal. Paranasal sinus CT revealed typical figures of rhinosinusitis. Histopathological examination indicated invasion by eo- sinophilic cell and fungal filament. After 12 months following -up, 15 patients had satisfactory outcome, and obtained well mucosal epi- thelization in nasal sinus. Four patients had occurred recurrence and one patient was lost. Conclusion The correct diagnosis is the ther- apy foundation for allergic fungal sinusitis patients. We recommend that combined treatment of surgery and criterional medicine can im- prove prognosis of allergic fungal sinusitis.

关 键 词：鼻-鼻窦炎 变应性 真菌 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]