鼻源性头痛临床治疗观察  

The Observation and Clinic Treatment of the Rhinogenous Headache

作　　者：王承华[1] 甘忠[1] 何金水[1] 董玉礼[1] 

机构地区：[1]武警广东总队医院耳鼻咽喉中心,广州市510507

出　　处：《中华全科医学》2013年第8期1175-1176,共2页Chinese Journal of General Practice

基　　金：广东省医学科研基金立项课题(A2012461)

摘　　要：目的探讨鼻腔结构异常及慢性鼻窦炎致鼻源性头痛临床治疗方法及效果。方法经筛选考虑为鼻源性头痛者术前常规行鼻内镜检查和/或鼻窦CT检查,明确鼻腔结构异常部位和慢性鼻窦炎的类型。对于鼻中隔偏曲、泡性中鼻甲、中鼻甲反向弯曲、钩突和/或筛泡肥大致鼻道窦口复合体狭窄等鼻腔结构异常的于鼻内镜下修正鼻腔结构;慢性鼻窦炎或伴有鼻息肉者根据其病变范围于全麻下行Messerklinger手术,清除鼻腔及鼻窦的病变组织,开放相应的鼻窦,术后定期清理术腔,并进行必要的药物治疗。结果经治疗200例鼻源性头痛患者,随访8～12个月,平均随访9个月。治愈146例,显效38例,有效13例,无效3例,总有效率98.5%。结论鼻源性头痛特别是鼻腔结构异常所致的容易误诊,经鼻内镜检查和/或鼻窦CT检查一般均可明确诊断,经相应的手术治疗可获得满意的治疗效果。Objective To explore the clinic therapeutic method and effect of rhinogenous headache caused by the textural anomaly of nasal cavity and the chronic nasosinusitis.Methods By means of screening,the routine nasal endoscope test and / or the paranasal sinus CT test for the patients of rhinogenous headache were performed,and then make sure the textural abnormal position of nasal cavity and the type of chronic nasosinusitis.Revise the nasal cavity structure in case of the textural anomoaly of nasal cavity,like the stenosis of the ostiomeatal complex caused by the deviation of nasal septum,bubble concha nasalis media,reversed bending concha nasalis media,processus uncinatus and / or ethmoidal bulb hypertrophy;do the Messerklinger operation for the patients with chronic nasosinusitis or nasal polyp on the basis of pathological change scopes under the general anesthesia,and clear away the pathological change tissue of the nasal cavity and paranasal sinus,dredge the relevant paranasal sinus;after the operation,clean the position periodically and accept the indispensable medicine therapy.Results Through the treatment,of 200 patients of rhinogenous headache,followed up for 8 to 12 months（average 9 months）.146 patients were cured,38 were effective significantly,13 were effective and 3 cases were invalid,with the total effective rate of 98.5%.Conclusion The rhinogenous headache,especially caused by the textural anomaly of nasal cavity,can be explicitly diagnosed via the nasal endoscope test and / or paranasal sinus CT test generally,and can be obtained an approving therapeutic effect through the corresponding operative treatment.

关 键 词：鼻源性头痛 鼻腔结构异常 慢性鼻窦炎 临床治疗 

分 类 号：R765[医药卫生—耳鼻咽喉科]