【摘要】：目的觀察真菌感染與鼻竇炎相關性,旨在探討鼻竇炎發(fā)生發(fā)展原因。方法選取2013年4月-2016年3月醫(yī)院鼻竇炎患者182例,其中鼻竇炎伴息肉90例設為觀察A組、不伴息肉92例設為觀察B組,選取同期健康體檢者90例作為對照組;比較三組研究對象真菌陽性切片檢出情況、真菌檢出分類及分析真菌感染與鼻竇炎伴息肉、不伴息肉相關性。結果觀察A組、觀察B組真菌檢出陽性率25.56%、20.65%高于對照組的18.89%,差異無統(tǒng)計學意義;觀察A組真菌檢出陽性率高于觀察B組,差異無統(tǒng)計學意義;按照真菌性鼻竇炎標準,三組研究對象切片中檢出真菌陽性切片59例,均為非侵襲型;其中三組研究對象真菌檢出曲霉菌占89.83%,高于毛霉菌的3.39%、白念珠菌的6.78%,差異有統(tǒng)計學意義(P0.05);但三組研究對象曲霉菌構成比較,差異無統(tǒng)計學意義;真菌感染與鼻竇炎伴息肉發(fā)生、不伴息肉發(fā)生無明顯相關性。結論真菌感染與鼻竇炎伴(或不伴)鼻息肉無明顯相關性,但不可否認鼻竇炎伴(或不伴)鼻息肉者真菌感染的存在,所以手術治療時徹底清除鼻竇腔內(nèi)全部真菌團塊等內(nèi)容物,充分開放竇腔、改善引流,最大限度保留竇腔正常黏膜、重建與確保術后長期自鼻竇至鼻腔的充分通氣與引流,有助于改變真菌賴于生存的局部環(huán)境。
[Abstract]:Objective to investigate the relationship between fungal infection and sinusitis. Methods 182 patients with sinusitis in hospital from April 2013 to March 2016 were selected. 90 patients with sinusitis and polyps were selected as observation group, 92 patients without polyps as observation group, 90 healthy persons as control group. The fungal positive sections were compared among the three groups. The fungi detection was classified and analyzed. The correlation between fungal infection and nasal sinusitis with polyp was not found. Results the positive rate of fungi detection in group A was 25.56% and 20.65% higher than that in control group (18.89%), but the positive rate of fungi in group A was higher than that in group B (no significant difference). According to the criteria of fungal sinusitis, 59 cases of fungal positive sections were found in the sections of the three groups, all of which were noninvasive. Aspergillus accounted for 89.83% in three groups, higher than 3.39% in Mucor and 6.78% in Candida albicans, the difference was statistically significant (P0.05). But there was no significant difference in the composition of Aspergillus among the three groups. There was no significant correlation between fungal infection and sinusitis associated with polyps without polyps. Conclusion there is no significant correlation between fungal infection and nasal polyps with or without sinusitis, but there is no denying the presence of fungal infection in sinusitis with or without nasal polyps. Therefore, during surgical treatment, we thoroughly cleared all the fungal lumps in the nasal sinuses, fully opened the sinus cavity, improved the drainage, maximized the preservation of the normal mucosa of the sinus cavity, and reconstructed and ensured the long-term adequate ventilation and drainage from the nasal sinus to the nasal cavity after surgery. It helps to change the local environment in which fungi depend on survival.
【作者單位】： 河南省人民醫(yī)院耳鼻喉科;
【基金】：河南省科技攻關基金資助項目(142102310078)
【分類號】：R765.41

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