鼻内镜下下鼻道外侧壁长方形开窗治疗真菌性上颌窦炎的临床效果

Clinical study of fungal maxillary sinusitis treat with rectangular fenestration in lateral wall of nasal passage under nasal endoscope

摘要:

目的 探讨鼻内镜下下鼻道外侧壁长方形开窗治疗真菌性上颌窦炎（FMS）的临床效果。方法 选取2015年1月－2019年12月该院收治的FMS患者200例作为研究对象。观察组（n = 100）采用鼻内镜下下鼻道外侧壁长方形开窗术治疗，对照组（n = 100）于鼻内镜下采用泪前隐窝入路治疗。观察两组患者手术时间、术中出血量及并发症发生率等情况。结果 观察组术中出血量64～100 mL，平均（78.5±8.4）mL，手术时间17～43 min，平均（29.5±5.8）min，术后随访1年，1例术侧空鼻综合征，治愈率为99.0%。对照组术中出血量62～108 mL，平均（81.4±8.5）mL，手术时间18～51 min，平均（32.4±6.5）min，术后随访1年，1例溢泪，1例术侧鼻腔粘连，1例术侧鼻腔狭窄，2例术侧空鼻综合征，治愈率为98.0%。两组患者术中出血量和手术时间比较，差异均有统计学意义（P < 0.05）；两组患者并发症发生率比较，差异无统计学意义（P > 0.05）。结论 鼻内镜下下鼻道外侧壁长方形开窗治疗FMS，手术时间短，出血量少，且操作简单、安全有效，值得临床推广应用。

Abstract:

Objective To investigate the effective value of treating fungal maxillary sinusitis with rectangular fenestration in the lateral wall of nasal passage under nasal endoscope.Methods 200 cases of fungal maxillary sinusitis from January 2015 to December 2019 were selected as the research subjects. The observation group (n = 100) was treated with rectangular fenestration at the lateralis wall of nasal passage under nasal endoscope, and the control group (n = 100) was treated with prelacrimal recess approach under nasal endoscope. The operation time, blood loss and complications were observed.Results The treatment group: the intraoperative bleeding was 64 ~ 100 mL, with an average of (78.5 ± 8.4) mL, the operation time was 17 ~ 43 min, with an average of (29.5 ± 5.8) min. The patients were followed up for one year, one case of empty nose syndrome, and the cure rate of the treatment group was 99.0%. Control group: the intraoperative blood loss was 62~108 mL, with an average of (81.4 ± 8.5) mL, the operation time was 18~51 min, with an average of (32.4 ± 6.5) min. The patients were followed up for one year, and the complications were: lacrimal effusion (1 case), nasal adhesions (1 case), nasal stenosis (1 case), empty nose syndrome (2 cases), the cure rate was 98.0%. There were significant differences in the intraoperative bleeding volume and the average operation time between the two groups (P < 0.05). There was no significant difference in complications rate between the two groups (P > 0.05).Conclusion Endoscopic rectangular fenestration of the lateral wall of the inferior nasal passage in the treatment of fungal maxillary sinusitis is simple with short time and less bleeding, safe and effective, which is worthy of clinical application.