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摘要: 目的: 探讨真菌性鼻-鼻窦炎(FRS)的临床特征。方法: 回顾分析近10年来鼻内镜下手术治疗的189例FRS患者的分类、发病年龄、好发部位、病因及治疗情况。结果: 189例患者中,真菌球性鼻-鼻窦炎(FB)181例,变应性真菌性鼻-鼻窦炎6例,急性侵袭性真菌性鼻-鼻窦炎1例,慢性侵袭性真菌性鼻-鼻窦炎1例。FB发生在上颌窦者128例(单侧123例,双侧5例),筛窦19例,蝶窦31例,上颌窦和筛窦均有病变2例,上颌窦和蝶窦均有病变1例。侵袭性FRS 2例均有糖尿病史。184例一次治愈,5例经历2次手术。结论: FRS的发病例数逐年递增,FB发病率高。对高度怀疑真菌感染的鼻窦炎应取分泌物涂片镜检、培养及组织病理学检查。手术治疗应彻底清除病变,避免再次手术。Abstract: Objective: To investigate the clinical features of fungal rhino-sinusitis.Method: Clinical data of 189 patients suffering from fungal rhino-sinusitis treated by functional endoscopic sinus surgery was analyzed retrospectively. The analyzed data included clinical type,age of onset,predilectionsite,reason, and surgical outcome.Result: Among the 189 patients with fungal rhino-sinusitis,181 cases were fungal ball,6 cases were allergic fungal rhino-sinusitis,1 case was acute invasive fungnal rhino-sinusitis,1 case was chronic invasive fungnal rhino-sinusitis. One hundred and twenty-eight cases were in the maxillary sinus(123 cases were unilateral,5 cases were bilateral).Nineteen cases were in the ethmoid sinus.31 cases were in the sphenoid sinus. Two cases were both in the maxillary sinus and ethmoid sinus,1 case was both in the maxillary sinus and sphenoid sinus. Two cases invasive fungnal rhino-sinusitis had diabetes history. All the patients treated by functional endoscopic sinus surgery, 184 cases without recurrence,5 cases suffered re-operation.Conclusion: The incidence of fungal rhinosinusitis is showing a rising trend, fungal ball is the highest. The sinusitis patients whom we highly doubt for fungal infection should be confirmed by using sinonasal secretion smear,cultivation and histopathological examination. Surgical treatment should completely remove the fungal masses, to avoid reoperation.
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Key words:
- sinusitis /
- fungal ball /
- surgical procedures
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