基层医院对鼻腔鼻窦非霍奇金淋巴瘤的诊疗体会  

Diagnosis and Treatment of Non-Hodgkin's Lymphoma in Primary Hospitals

作　　者：周鲁盛 郭凯 Zhou Lu-sheng;Guo Kai(Department of Otolaryngology,Laizhou People's Hospital,Laizhou 261400,Shandong Province,China)

机构地区：[1]山东莱州市人民医院耳鼻喉科,山东莱州261400

出　　处：《中外医药研究》2023年第4期62-64,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：该研究回顾性分析2020年3月—2022年10月就诊于莱州市人民医院耳鼻喉科的4例鼻腔、鼻窦非霍奇金淋巴瘤(NHL)患者资料,4例患者均进行了详细问诊、专科查体,并有完善的辅助检查:鼻内镜检查、影像学检查、实验室检查、鼻部组织活检病理学检查。4例患者均有鼻部症状且多为首发表现,包括鼻塞、流涕、血性涕,并可同时伴有头痛、眼部不适等症状。1例术后活检明确诊断,2例经多次病理活检确诊,1例因病理报告组织分型不一致,多家医院会诊后确诊。在基层医院临床中如遇经规范治疗无效的鼻炎、鼻窦炎,且专科查体特征有鼻腔广泛结痂、坏死,下鼻甲肿胀或伴有不能解释的头痛、复视、溢泪、突眼患者,应警惕鼻腔、鼻窦NHL可能,基层医院耳鼻喉科接诊类似患者应完善鼻腔、鼻窦检查,尽早活检,同时注意活检取材部位,以期早诊断、早治疗,提高患者有效生存率。This study retrospectively analyzed the data of 4 patients with nasal cavity and sinus non-Hodgkin lymphoma(NHL)who were treated in the Department of Otorhinolaryngology,Laizhou People's Hospital from March 2020 to October 2022.All 4 patients underwent detailed consultation,specialized physical examination,and complete auxiliary examinations:nasal endoscopy,imaging examination,laboratory examination,and pathological examination of nasal tissue biopsy.All 4 patients had nasal symptoms and most of them were the first symptom,including nasal congestion,runny nose,and bloody nasal discharge,accompanied by headache,eye discomfort and other symptoms.1 case was confirmed by postoperative biopsy,2 cases were confirmed by multiple pathological biopsies,and 1 case was diagnosed after consultation with multiple hospitals due to inconsistent tissue types in pathology reports.In case of rhinitis and sinusitis that are ineffective after standardized treatment in primary hospitals,and specialist physical examination features extensive nasal scab,necrosis,inferior turbinate swelling or accompanied by unexplained headache,diplopia,epiphora,exophthalmos patients,the possibility of NHL in the nasal cavity and sinuses should be alerted.The otolaryngology department of the primary hospital should complete the examination of the nasal cavity and sinus for similar patients,and biopsy as soon as possible.At the same time,pay attention to the location of the biopsy material,so as to make early diagnosis and treatment,and improve the effective survival rate of patients.

关 键 词：基层医院 非霍奇金淋巴瘤 NK/T细胞淋巴瘤 弥漫大B细胞淋巴瘤 诊断 

分 类 号：R73[医药卫生—肿瘤]