鼻硬结病的研究进展  

Research progress of rhinoscleroma

作　　者：史亚男[1] 张桂敏[1] 季冉 王巍[1] 林鹏[1] SHI Ya-nan;ZHANG Gui-min;JI Ran;WANG Wei;LIN Peng(Department of Otolaiyngology Head and Neck Surgery,Tianjin First Central Hospital,Tianjin Institute of Otolaryngology,Tianjin Key Clinical discipline of Otolaryngology,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院耳鼻咽喉头颈外科,天津市耳鼻喉科研究所,天津市耳鼻喉科学临床重点学科,天津300192

出　　处：《中国城乡企业卫生》2021年第6期39-43,共5页Chinese Journal of Urban and Rural Enterprise Hygiene

基　　金：天津市自然科学基金项目(19JCYBJC27200)。

摘　　要：鼻硬结病是一种由克雷伯鼻硬结杆菌(KR)引起的十分罕见的慢性、低传染性、肉芽肿性疾病,病变常见于鼻腔,亦可以累及呼吸道的其他部位。鼻硬结病发生的确切机制目前尚不明确。其病理改变可分为3个阶段:卡他期、硬节期及瘢痕期,在各个时期会出现不同的特征性病理改变,但也可以同时存在或者呈现过渡状态。鼻硬结病的症状、体征及影像学表现均缺乏特异性,易导致误诊进而延误治疗,影响治疗效果。该病以抗生素治疗为主,但治疗时间较长,患者症状缓解较慢,且长期用药易产生不良反应。一些特殊类型鼻硬结病可以通过手术治疗或放射治疗使患者症状得到缓解。因鼻硬结病比较少见且其发病有一定地域性,故目前国内外对该病的研究多以病例报道为主。本文系统地回顾了国内外相关文献,对鼻硬结病近期研究进展进行综述,为鼻硬结病的临床诊断及治疗提供参考方案。Rhinoscleroma is a very rare chronic,low transmission,granulomatous disease caused by Klebsiella rhinoscleromatis(KR).The lesions are common in the nasal cavity and can also involve other parts of the respiratory tract.The exact mechanism of rhinoscleroma is still unclear.The pathological changes can be divided into three stages:catarrhal stage,hard segment stage and scar stage,there are different characteristic pathological changes in different periods,but they can also exist at the same time or present a transitional state.The symptoms,signs and imaging findings of rhinoscleroma are lack of specificity,so it is easy to lead to misdiagnosis and delay the treatment,thus affecting the therapeutic effect.The disease is mainly treated with antibiotics,but the treatment time is longer,the patient’s symptoms relieve slowly,and long-term medication is easy to produce adverse reactions.Some special types of rhinoscleroma can be relieved by surgery or radiotherapy.Because rhinoscleroma is relatively rare and its incidence has a certain region,so at present,most of the studies on this disease at home and abroad are based on case reports.This article systematically reviews the relevant literature at home and abroad and reviews recent research advances of rhinoscleroma,to provide reference scheme for the clinical diagnosis and treatment of rhinoscleroma.

关 键 词：鼻硬结病 诊断 治疗 

分 类 号：R765.22[医药卫生—耳鼻咽喉科]