52例鼻窦真菌球临床特征分析  

Clinic characters analysis of 52 cases with sinus fungus ball disease

作　　者：魏欣[1] 粘家斌[1] 王刚[1] 张余良[1] 蔡圣恩 刘术舟[1] 

机构地区：[1]海南省人民医院耳鼻咽喉头颈外科海南省耳鼻咽喉头颈外科医院,海口570311

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第22期1754-1757,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：海南省自然科学基金项目(No:814312)

摘　　要：目的:分析鼻窦真菌球发病的临床特点,探讨与鼻窦真菌球发生的相关因素,提高对鼻窦真菌球的认识。方法:回顾性分析52例已手术治疗的鼻窦真菌球患者,从年龄、性别、职业、病变侧别、累及鼻窦组数、有无息肉、有无鼻中隔偏曲、泡状中甲、中甲反张、眶下气房以及血常规白细胞分类、血清特异性IgE、致病真菌种类等方面进行统计学分析。结果:52例鼻窦真菌球患者中,病变为单一上颌窦36例,单一筛窦1例,单一蝶窦4例;病变为2组鼻窦7例,均为上颌窦和筛窦组合;病变为3组鼻窦4例,其中上颌窦、筛窦、蝶窦组合2例,上颌窦、筛窦、额窦组合2例。左侧26例,右侧17例,双侧8例。曲霉菌是鼻窦真菌球最主要的致病菌,上颌窦是鼻窦真菌球最好发的单一鼻窦,鼻息肉在多窦真菌球中更常见(P<0.01),单一蝶窦真菌球在糖尿病患者中更为常见(P<0.01)。鼻窦真菌球发生侧别与鼻中隔偏曲、泡状中甲、中甲反张、眶下气房等鼻部解剖结构异常无关。结论:上颌窦真菌球是鼻窦真菌球最为常见的类型,曲霉菌是鼻窦真菌球最常见的致病菌,多窦真菌球更容易伴鼻息肉,单一蝶窦真菌球在糖尿病患者中更常见,真菌球发生侧别与鼻腔常见解剖结构异常无关。Objective：To explore the clinic characters and the associated factors for the onset of the sinus fungus ball disease.Method：Analyze 52 cases who have received surgery with sinus fungus ball disease retrospectively.The effect factors of age,sex,occupation,the side of the lesion,involving sinus group number,accompany with merger polyps or not,presence of nasal septum deviation,vesicular middle turbinate,paradoxical middle turbinate,infraorbital cells,routine blood leukocyte classification,serum specific IgE,pathogenic fungi species have all been taken into consideration for statistical analysis.Result：In 52 cases of sinus fungus ball disease,36 cases only suffered in maxillary sinus,1case only suffered in ethmoid sinus,4cases only suffered in sphenoid sinus,7cases suffered from two sinus lesions with the combination of maxillary sinus and ethmoid sinus in all,4cases fuffered from three sinus lesions with the combination of maxillary sinus,ethmoid sinus and sphenoid sinus in 2cases,maxillary sinus,ethmoid sinus and frontal sinus in 2cases.26 cases have the lesion on left side,17 cases on the right side,8cases on both sides.Aspergillus is the main pathogenic fungus for sinus fungus ball.Maxillary sinus is the most susceptible single sinus for sinus fungus ball.Nasal polyps is commonly seen in multiple sinuses fungus ball（P〈0.01）.Single sphenoid sinus fungus ball is more commonly seen in the patients with diabetes mellitus（P〈0.01）.Lesion side of sinus fungus ball has nothing to do with the nasal anatomy abnormalities of nasal septum deviation,vesicular middle turbinate,paradoxical middle turbinate,infraorbital cells.Conclusion：The present study indicates that maxillary sinus fungus ball is the most common type for sinus fungus ball.Aspergillus is the main pathogenic fungus for sinus fungus ball.Nasal polyps is more involved in multiple sinuses fungus ball,Single sphenoid sinus fungus ball is more commonly seen in the patients with diabetes mellitus.Lesion side of sinus fungus ball has none relation

关 键 词：鼻窦 真菌球 鼻窦炎 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]