鼻内镜手术中保留钩突40例临床分析(1)
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【摘要】目的探讨保留钩突在鼻内窥镜手术中的意义,保留钩突的FESS更符合鼻腔生理特点。方法40例单纯慢性鼻窦炎患者为实验组,实验组施行经鼻内镜下保留钩突的功能性鼻内窥镜手术,40例单纯慢性鼻窦炎为对照组,对照组采取经典钩突切除术。结果随访6个月,实验组治愈36例,好转2例,无效2例,有效率95.0%。对照组治愈29例,好转3例,无效8例,总有效率80.0%,两组总有效率比较P<0.05。实验组术后并发症较对照组明显减少。结论保留钩突的功能性鼻内窥镜手术,保留了鼻腔的正常结构,使手术更加适应鼻腔鼻窦的气流特征,减少了鼻窦黏膜炎症的复发机会。
【关键词】
鼻内镜;钩突;鼻窦炎
Retain Uncinate Process of the Nasal Cavity after Funcitional Endoscopic Sinus Surgery
LVLingyan,ZHOU Xuanyan,ZHANG qian,et al.Department of Otolaryngology,Liaocheng Second People’s Hospital,Linqing,Shandong Liaocheng,252601,China
【Abstract】ObjectiveTo explore the significance of retain uncinate process of the nasal cavity in endoscopic sinus surgery,Retained uncinate process of the FESS is more suitable to the physiological characteristics of the nasal cavity.MethodsIn the observation group,40cases of smiple chronic sinusitiswere received the functional endoscopic sinus surgery and uncinate process of the nasal cavity were preserved.40cases of smiple chronic sinusitis as controlgroup were received classical uncinate process resection.ResultsBy the end of six month following treatment,35 cases were cured,4 cases were effective,1 cases were ineffective in TG,and30 cases were cured,5 cases were effective,4 cases were ineffective inCG.the effective rates were 94.8% and 84.7% for TG and CG respectively,with significant difference between them(P<0.05).The complication rate in observation group after 6 months of the surgerywas lower than that of controlgroup.ConclusionThe FESS retained uncinate process retains the normal structure of nasal cavity,is more suitable to the Characteristics of nasal airflow.Reduced the recurrence of sinus mucosal inflammation opportunity
【Key words】
Endoscopic;Uncinate process; Nasosinusitis
目前国际流行的功能性内窥镜鼻窦手术已成为治疗鼻部疾病的主要手段,临床上施行的FESS多采用Messerklinger术式,主要步骤为切除钩突,由于钩突的切除使窦口充分暴露,解决了窦口闭道复合体阻塞和各个鼻窦的引流问题,但同时也改变了鼻腔气流方向,使各鼻窦天然保护屏障消失,全部窦腔暴露于气流冲击之下,增加了逆行感染及鼻腔鼻窦黏膜再次炎性病变的机率,且在术腔黏膜转归阶段中容易发生新的病变,从而阻碍了术腔上皮化。我们对2008年1月至2008年10月收治的40例单纯型慢性鼻窦炎患者施行了保留钩突的FESS,现总结如下。
1资料与方法
1.1临床资料根据患者的症状、体征及鼻窦CT检查结果,我们筛选了钩突结构和形态基本正常,无多发性鼻息肉或解剖变异的单纯慢性鼻窦炎患者80例,所有患者术前均无手术史。按照海口标准[1]的分类分型方法,均属于I型2期和3期。其中Ⅰ型2期53例,Ⅰ型2期27例。合并上颌窦囊肿5例、蝶窦囊肿2例、鼻中隔偏曲16例、鼻甲肥大9例 ......
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