摘要
目的 探讨功能性鼻内窥镜手术加抗真菌药物灌注术腔治疗非侵袭性真菌性鼻窦炎的疗效及影响疗效的因素。方法 :分析 1997～ 2 0 0 1本院行功能性鼻内窥镜手术 (FunctionalEndoscopicSinusSurgery ,FESS)治疗非侵袭性真菌性鼻窦炎 38例的手术径路及抗真菌性药物的使用对疗效的影响。结果 所有病例都在其霉菌团块找到曲霉菌菌丝或孢子 ;双径路 (经尖牙窝或下鼻道加上颌窦自然窦口 )术式的术后愈合期为 3.9± 0 .8周 ,而单路径(经上颌窦自然开口 )术式的术后愈合期为 11.3± 0 .6周 ,两组差异有显著性 (P 0 .0 1)。双径路中使用抗真菌药物灌注术腔组的术后愈合期为 3.4± 0 .3周 ,而未使用抗真菌药物组的术后愈合期为 4 .0± 0 .7周 ,其差异无显著性 (P 0 .0 5 )。单径路中使用抗真菌药物组冲洗术腔的术后愈合期为 11.6± 0 .9周 ,而未使用抗真菌药物组的术后愈合期为 11.2± 0 .7周 ,其差异无显著性 (P 0 .0 5 )。 38例经随访 13～ 4 0月 ,有 4例复发 ,均为未使用抗真菌药物冲洗术腔患者。结论 霉菌团块标本对非侵性袭性鼻窦真菌病的诊断具有重要意义 ,是治疗非侵性袭性鼻窦真菌病有效方法 ,双径路优于单径路 ,是否使用抗真菌药物冲洗术腔对术后愈合期无明显影响 ,但未使用抗真菌药物冲洗术腔患者?
objective To evaluate the treatment of the paranasal sinuses mycosis by using functional endoscopic sinus surgery (FESS) and anti fungal drugs and the correlated factors.Methods Tirty eight cases of local, the non invasive paranasal sinuses mycosis treated with FESS or anti fungal drugs from 1997 to 2001 were studied.Results The mycelium or spore was found in the mildew blocks of all patients.The period of convalescence of double pathway(via ostium of maxillary sinus and anine fossa)was 3.9±0.8 weeks while single pathway(via ostium of maxillary sinus only)was 11.3±0.6 weeks( P <0.01).The period of convalescence of group of double pathway using anti fungal drugs to wash the operative cavity was 3.4±0.3 weeks while the group without using drugs was 4.0±0.7 weeks.There was no significant difference( P >0.05).The period of convalescence of group of single pathway using anti fungal drugs to wash the operative cavity was 11.6±0.9 weeks while the group without using drugs was 11.2±0.7 weeks,There was no significant difference( P >0.05).In follow up of 13 months to 40 months,recurrence occurred in 4 cases without using anti fungal drugs to wash the operative cavity.Conclusion Mildew conglomeration is important in diagnosis of non invasive paranasal sinuses mycosis.FESS is effective in treating of the paranasal sinuses mycosis.The operation of double pathway is superior to that of single pathway.There is no obvious effect on the convalescence period whether to use anti fungal drugs to wash the operative cavity or not. But the cases without using anti fungal drugs to wash the operative cavity is easily recurrent.
出处
《江西医学院学报》
2003年第3期55-57,共3页
Acta Academiae Medicinae Jiangxi
关键词
鼻内窥镜手术
鼻窦
真菌病
endoscopic sinus surgery
mycosis
paranasal sinuses
