非侵袭性上颌窦曲菌病43例临床分析  

Clinical analysis of 43 non-invasive aspergillosis of the maxillary sinus

作　　者：冯立人[1] 郭庆明[2] 

机构地区：[1]东南大学附属中大医院耳鼻咽喉科,江苏南京210009 [2]东南大学附属中大医院病理科,江苏南京210009

出　　处：《中国耳鼻咽喉颅底外科杂志》2001年第4期226-228,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的　探讨非侵袭性上颌窦曲菌病的临床特点及经鼻内镜治疗的价值。方法　总结 1993- 1999年在我院行鼻内镜鼻窦手术 (EndoscopicSinusSurgery ,ESS)治疗的非侵袭性上颌窦曲菌病 43例 ,分析该疾病的诊断、治疗及影响疗效和转归的因素。结果　所有病例都在其霉菌团块中找到曲霉菌菌丝或孢子 ;双径路 (经尖牙窝或下鼻道加上颌窦自然窦口 )术式的术后愈合期为 4.9周 ,而单径路 (经上颌窦自然窦口 )术式的术后愈合期为 10 .2周 ,2组差异有显著性 (P <0 .0 1) ;使用抗真菌剂冲洗术腔组的术后愈合期为 6 .6周 ,未使用抗真菌剂组的术后愈合期为 7.3周 ,但其差异无显著性 (P >0 .0 5 )。结论　霉菌团块标本对非侵袭性鼻窦真菌病的诊断具有重要意义 ;ESS是治疗非侵袭性上颌窦曲菌病的有效方法 ,双径路疗效优于单径路 ;是否使用抗真菌剂冲洗术腔对疗效无明显影响。Objective To determine the clinical characteristics of non-invasive aspergillosis of the maxillary sinus and evaluate the treatment by endoscopic sinus surgery (ESS). Methods Forty-three cases of non-invasive aspergillosis of the maxillary sinus treated with ESS from 1993 to 1999 were studied. Results The mycelium or spore was found in the mildew blocks of all patients. The convalescence period of double pathway (via ostium of maxillary sinus + canine fossa or inferior meatus) was 4.9 weeks while that of single pathway (via ostium of maxillary sinus only) was 10.2 weeks. There was significant difference (P< 0.01). The convalescence period of the group using anti-fungal medicine to wash the operative cavity was 6.6 weeks while that of the group without using drugs was 7.3 weeks. There was no statistical significance (P> 0.05). Conclusion Mildew conglomeration is important in diagnosing non-invasive aspergillosis of the maxillary sinus. ESS is an effective means in treating this disorder. Double pathway is superior to single pathway. There is no obvious effect on the efficacy whether to use anti-fungal drugs to wash the operative cavity or not.

关 键 词：鼻窦炎 曲霉病 内镜术 上颌窦 

分 类 号：R519.8[医药卫生—内科学] R765.41[医药卫生—临床医学]