摘要
目的通过对鼻内镜手术治疗鼻腔黏膜接触性头痛的临床观察，探讨鼻腔黏膜接触区与头痛的相关性。方法回顾性分析45例经鼻内镜手术治疗的鼻腔黏膜接触性头痛患者术前、术后6、18、24个月的头痛强度、头痛频率、持续时间、总时间的差异。数据采用SPSS18．0统计软件进行秩和检验。结果鼻内镜术后6、18、24个月头痛强度（以中位数[25分位数；75分位数]表示）视觉模拟量表评分分别为1．50[0；4．00]、2．00[0；5．00]、3．25[0；5．75]分，分别较术前的6．00[5．25；8．25]分明显减轻（Z值分别为-4．913、-4．070、-3．095，P值均〈0．01）；鼻内镜术后6、18、24个月头痛总时间分别为0．07[0；3．50]、0．26[0；7．77]、1．04[0；／7．15]h，分别较术前的25．20[4．00；186．00]h明显缩短（Z值分别为-4．368、-3．652、-2．500，P值均〈0．05）。结论鼻腔黏膜接触是难治性头痛的重要原因之一，鼻内镜下纠正解剖异常可缓解头痛，但头痛机制复杂，鼻腔黏膜接触不是难治性头痛的惟一病因。术后应长期随访以观察远期疗效。
Objective To verify the correlation between nasal contact point and headache and to discuss the significance of nasal endoscopic surgery through observation of clinical outcomes in patients with nasal mucosa contact point treated by endoscopic surgery. Methods Forty-five patients diagnosed as nasal mucosa contact headache were treated by nasal endoscopic surgery. The results were analyzed retrospectively, including headache degree, headache frequency, lasting time and total time between before and6, 18, and 24 months after operation. The data were processed by rank-sum test by SPSS 18. 0 software. Results 6, 18 and 24 months after operation, the headache degree （ VAS scores were 1.50 [ 0 ; 4.00], 2.00 [0; 5.00], 3.25 [0; 5.75], respectively） was relieved （VAS score was 6.00[5.25; 8.25 ] before operation） dramatically （ Z value were - 4. 913, - 4.070 and - 3. 095, respectively, all P 〈 0.01 ）. The total time of headache 6, 18, 24 months after operation （ It were O. 07 [ 0 ; 3.50 ], 0.26 [ 0 ; 7.77], 1.04 [0; 17. 15 ] h, respectively） was shortened （It was 25.20 [4.00; 186.00 ] h before operation） significantly （Z value were - 4. 368, - 3. 652, - 2. 500, respectively, all P 〈 0.05）. Conclusions One of the key causes of patients suffered from intractable headaches is mucosal contact in the nasal cavity. The pain in these patients could be relieved through surgical correction of intranasal anatomic abnormalities. Nasal mucosa contact might not be the only etiology of intractable headache since the mechanism of headache is complicated and variable. The effect of endoscopic surgery needs to be estimated by long-term follow-up.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2012年第4期317-320,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
头痛
鼻疾病
鼻塞
Headache
Nose diseases
Nasal obstraction
