本文選題：解剖學(xué)　切入點：慢性鼻-鼻竇炎　出處：《大連醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討鼻腔鼻竇結(jié)構(gòu)異常與慢性鼻竇炎的相關(guān)性，探討鼻腔鼻竇不同的結(jié)構(gòu)異常在慢性鼻竇炎發(fā)生發(fā)展中的作用。 方法：回顧性分析2009年12月—2011年12月在我院接受功能性鼻內(nèi)鏡手術(shù)的患者235例，根據(jù)鼻竇CT、鼻內(nèi)鏡下及術(shù)中所見的情況，記錄鼻中隔偏曲、中鼻甲肥大、泡狀中鼻甲、中鼻甲反張、鉤突肥大的解剖變異情況，本研究根據(jù)慢性鼻-鼻竇炎患者是否合并有鼻息肉生長分為兩大組，A組：單純型慢性鼻竇炎（保守治療無效）；B組：慢性鼻竇炎伴有鼻息肉；同時，按照檢查結(jié)構(gòu)將鼻息肉分為3級：I級：單發(fā)鼻竇炎伴單發(fā)鼻息肉；II級：多發(fā)鼻竇炎伴多發(fā)鼻息肉；III級：全組鼻竇炎伴多發(fā)鼻息肉。對合并鼻息肉的鼻竇炎患者與不伴息肉的鼻竇炎患者在鼻腔結(jié)構(gòu)解剖變異方面相比較，分析其相關(guān)性。 結(jié)果：功能性鼻內(nèi)鏡手術(shù)治療慢性鼻-鼻竇炎總的治愈率為78.9%，好轉(zhuǎn)率為17.3%，無效率為3.8%。不同組別的鼻竇炎患者中，，鼻中隔偏曲、中鼻甲肥大及鉤突肥大檢出率差異有統(tǒng)計學(xué)意義；中鼻甲反向偏曲、泡狀中鼻甲及下鼻甲肥大檢出率無明顯統(tǒng)計學(xué)意義；伴有鼻息肉的慢性鼻-鼻竇炎患者鼻腔鼻竇結(jié)構(gòu)異常的檢出率高于單純型慢性鼻-鼻竇炎患者，且隨病變的嚴(yán)重程度增加，鼻腔鼻竇解剖異常檢出率增高；在不同組別的慢性鼻-鼻竇炎患者中，不同類型的鼻中隔偏曲檢出率差異有統(tǒng)計學(xué)意義（x2=6.64P0.05），且鼻中隔高位偏曲的患者檢出率高于非鼻中隔高位偏曲患者。 結(jié)論：鼻腔鼻竇結(jié)構(gòu)異常與慢性鼻-鼻竇炎的發(fā)生有著密切的關(guān)系，其中較為常見的結(jié)構(gòu)異常為鼻中隔偏曲、中鼻甲肥大及鉤突肥大。
[Abstract]:Objective: to investigate the relationship between the abnormal structure of nasal cavity and paranasal sinus and chronic sinusitis, and to explore the role of different structural abnormalities of nasal cavity and paranasal sinus in the occurrence and development of chronic sinusitis.Methods: 235 patients undergoing functional endoscopic sinus surgery in our hospital from December 2009 to December 2011 were retrospectively analyzed. According to CT, endoscopic and intraoperative findings, nasal septum deviation, middle turbinate hypertrophy, and bubbly middle turbinate were recorded.Anatomic variation of middle turbinate regurgitation and uncinate process hypertrophy,In this study, patients with chronic rhinosinusitis and nasal polyps were divided into two groups: simple chronic sinusitis (group B: chronic sinusitis with nasal polyps) and chronic sinusitis with nasal polyps.The nasal polyps were divided into three grades according to the examination structure: single sinusitis with single nasal polyp grade II, multiple sinusitis with multiple nasal polyp grade III: sinusitis with multiple nasal polyps.To compare the anatomic variation of nasal cavity structure between sinusitis patients with nasal polyps and sinusitis patients without polyps, and analyze its correlation.Results: the total cure rate of functional endoscopic surgery for chronic rhinosinusitis was 78.9, the improvement rate was 17.3and the inefficiency was 3.8%.The positive rates of nasal septum deviation, middle turbinate hypertrophy and uncinate process hypertrophy were significantly different among different groups of sinusitis patients, but there was no significant difference in the detection rate of middle turbinate reverse deviation, bubble middle turbinate and inferior turbinate hypertrophy.The detection rate of nasal cavity and sinusitis in patients with chronic rhinosinusitis with nasal polyps was higher than that in patients with simple chronic rhinosinusitis.In different groups of patients with chronic rhinosinusitis, the positive rate of nasal septum deviation was significantly higher in patients with nasal septum deviation than that in non-nasal septum high deviation patients.Conclusion: the abnormal structure of nasal cavity and sinusitis is closely related to the occurrence of chronic rhinosinusitis, among which the common structural abnormalities are nasal septum deviation, middle turbinate hypertrophy and uncinate process hypertrophy.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R765.9

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