285例真菌性鼻-鼻窦炎的临床及病原菌分析  

Clinical feature and pathogen analysis of 285 cases of fungal rhinosinusitis

作　　者：邹柳凤 朱雅静 郑毅洋 康渊春 谢铠鹏 伍小琴 彭浒 廖建春 ZOU Liufeng;ZHU Yajing;ZHENG Yiyang;KANG Yuanchun;XIE Kaipeng;WU Xiaoqin;PENG Hu;LIAO Jianchun(Department of otolaryngology Head and Neck Surgery,the Second Hospital of Zhangzhou,Zhangzhou 363100,China;Department of otolaryngology Head and Neck Surgery,Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;Department of otolaryngology Head and Neck Surgery,909 Hospital of the Joint Service Support Force of the People’s Liberation Army of China,Fujian 363000,China)

机构地区：[1]漳州市第二医院耳鼻咽喉头颈外科,漳州363100 [2]海军军医大学第二附属医院耳鼻咽喉头颈外科,上海200003 [3]解放军联勤保障部队909医院耳鼻咽喉头颈外科,漳州363000

出　　处：《中国真菌学杂志》2023年第6期507-510,共4页Chinese Journal of Mycology

基　　金：国家自然基金项目(81770980);上海市卫计委科研项目(201640182)。

摘　　要：目的多中心回顾性探究慢性真菌性鼻-鼻窦炎临床特征和病原学特点,加深临床对慢性真菌性鼻-鼻窦炎的认识。方法采用多中心回顾性研究的方法,对海军军医大学第二附属医院、漳州市第二医院及解放军联勤部队909医院,从2008年1月—2018年1月期间收治的285例慢性真菌性鼻-鼻窦炎病例中系统分析该疾病的临床表现、菌种分析、影像解剖学、病理学检查以及治疗方法。结果285例慢性真菌性鼻-鼻窦炎患者中,临床表现主要以鼻塞(50.18%)、头痛(40.70%)、流涕(16.49%)为主,发病多为单侧上颌窦发病(67.37%);影像学特点为变鼻腔鼻窦内软组织结节状或息肉状不规则增生,其上多见点状或斑块状高密度钙化,侵袭病变可见骨质破坏;手术是治疗慢性真菌性鼻-鼻窦炎的主要方式,285例患者均采用鼻内镜手术治疗,术中术后均未出现严重并发症;术后病原学检测发现曲霉感染241例(84.56%),毛霉感染22例(7.71%)。结论慢性真菌性鼻-鼻窦炎是具有典型影像学表现的慢性鼻-鼻窦炎,多为曲霉感染导致的单侧上颌窦发病,鼻内镜下手术治疗效果显著。Objective To explore the clinical feature and pathogens of chronic fungal rhinosinusitis through a multicenter retrospective study,in order to deepen clinical understanding of chronic fungal rhinosinusitis.Methods A systematic analysis was conducted on the clinical manifestations,pathogenic analysis,imaging anatomy,pathological examination,and treatment methods of 285 cases of chronic fungal rhinosinusitis admitted to the Second Affiliated Hospital of Naval Medical University,the Second Hospital of Zhangzhou,and the 909 Hospital of the People's Liberation Army Joint Service from January 2008 to January 2018.Results Among the 285 patients,the main clinical characteristics were rhinobyon(50.18%),headache(40.70%),and runny nose(16.49%),with the majority of cases occurring in the unilateral maxillary sinus(67.37%).The imaging features were irregular nodular or polyp like hyperplasia of soft tissue in the nasal cavity and sinuses,with more punctate or patchy high-density calcification on top,and invasive lesions with visible bone destruction.The surgery was the main treatment for chronic fungal sinusitis.All 285 patients underwent endoscopic sinus surgery without any serious complications during or after the operations.Pathogenic testing revealed 241 cases(84.56%)of Aspergillus infection and 22 cases(7.71%)of Mucor infection.Conclusion Chronic fungal rhinosinusitis is a chronic rhinosinusitis with typical imaging manifestations,mostly unilateral maxillary sinus pathogenesis due to Aspergillus infection.Endoscopic surgery is safe and effective in the treatment of fungal maxillary sinusitis.

关 键 词：慢性真菌性鼻-鼻窦炎 临床特征 病原菌 

分 类 号：R519[医药卫生—内科学] R765.4[医药卫生—临床医学]