鼻中隔偏曲與慢性鼻—鼻竇炎關(guān)系的探討
發(fā)布時(shí)間：2019-01-15 07:54
【摘要】：目的通過對(duì)鼻竇CT分析探討鼻中隔偏曲與慢性鼻-鼻竇炎不伴鼻息肉(chronic rhinosinusitis without nasal polyps,CRSs NP)發(fā)病的相關(guān)性。方法對(duì)185例鼻中隔偏曲患者行鼻內(nèi)鏡、鼻竇軸位和/或冠位CT掃描觀察,所有鼻竇CT均采用Lund-Machay CT評(píng)分系統(tǒng)評(píng)估鼻竇炎發(fā)病情況。分析并統(tǒng)計(jì)鼻中隔偏曲方向、程度、鼻中隔偏曲位置在鼻竇炎組和正常對(duì)照組中的發(fā)病率。與鼻中隔偏曲方向一致的一側(cè)鼻腔稱為窄側(cè),反之為寬側(cè),分析寬窄兩側(cè)鼻竇炎發(fā)病率;根據(jù)張劍寧分組方法將鼻中隔偏曲合并慢性鼻-鼻竇炎不伴鼻息肉分為A、B、C、D、E、F六組,分析并統(tǒng)計(jì)各偏曲組慢性鼻-鼻竇炎不伴鼻息肉發(fā)病率;通過鼻內(nèi)鏡觀察鼻中隔偏曲兩側(cè)鼻腔結(jié)構(gòu)改變情況。結(jié)果185例鼻中隔偏曲患者中,并發(fā)CRSs NP的有129例,發(fā)病率為69.73%,其中鼻中隔偏曲寬側(cè)并發(fā)CRSs NP的有87例,發(fā)病率較高,為67.44%;鼻中隔偏曲窄側(cè)并發(fā)CRSs NP的有42例,發(fā)病率為32.56%;1、鼻竇炎組與對(duì)照組中鼻中隔偏曲方向比較差異無統(tǒng)計(jì)學(xué)意義;鼻中隔偏曲程度在鼻竇炎組和正常組之間比較,鼻中隔偏曲程度與慢性鼻竇炎之間有統(tǒng)計(jì)學(xué)差異,中重度鼻中隔偏曲與CRSs NP有相關(guān)性;鼻中隔偏曲位置組之間比較,鼻中隔偏曲位置在鼻竇炎組與正常對(duì)照組之間有統(tǒng)計(jì)學(xué)意義,鼻中隔高位偏曲與CRSs NP有相關(guān)性。2、根據(jù)Lund-Mackay鼻竇CT評(píng)估和計(jì)分方法,對(duì)入組患者鼻竇炎嚴(yán)重程度進(jìn)行統(tǒng)計(jì)后發(fā)現(xiàn),鼻腔寬側(cè)部分鼻竇渾濁居多,其中以上頜竇、前組篩竇較顯著。3、根據(jù)張劍寧對(duì)鼻中隔偏曲分組,185例鼻中隔偏曲患者中,有129例并發(fā)CRSs NP,其中A組合并CRSs NP有12例;B組合并CRSs NP有14例;C組合并CRSs NP有15例;D組(高位,篩骨垂直板)合并CRSs NP有56例;E組合并CRSs NP有11例;F組合并CRSs NP有21例。其中高位偏曲組(D、F組)CRSs NP發(fā)病率最高,共77例。4、鼻中隔偏曲并發(fā)CRSs NP雙側(cè)鼻腔檢查結(jié)果顯示:中、下甲及鉤突肥大等結(jié)構(gòu)變異更常見于寬側(cè)鼻腔;中甲反向屈曲和中甲受壓多見于窄側(cè)鼻腔。結(jié)論1、鼻中隔偏曲患者中CRSs NP發(fā)病率較高,鼻中隔中重度偏曲及鼻中隔高位偏曲與CRSs NP的發(fā)生有相關(guān)性。2、鼻中隔偏曲寬側(cè)CRSs NP發(fā)病率高于窄側(cè),鼻中隔偏曲寬側(cè)上頜竇、前組篩竇發(fā)病率較顯著。3、鼻中隔偏曲各分組中D、F組CRSs NP發(fā)病率較高。4、鼻中隔偏曲寬側(cè)中鼻甲、下鼻甲及鉤突肥大;中甲反向屈曲和中甲受壓則常見于窄側(cè)鼻腔。
[Abstract]:Objective to investigate the relationship between nasal septum deviation and chronic rhinosinusitis without nasal polyp (chronic rhinosinusitis without nasal polyps,CRSs NP) by CT analysis of paranasal sinuses. Methods CT scanning was performed in 185 patients with nasal septum deviation. The incidence of sinusitis was evaluated by Lund-Machay CT scoring system in all cases. The incidence of nasal septum deviation in sinusitis group and normal control group was analyzed and analyzed. The side of nasal cavity which is consistent with the direction of deviation of nasal septum is called narrow side and vice versa. The incidence of sinusitis on both sides of nasal septum is analyzed. According to Zhang Jianning's grouping method, the nasal septum deviation combined with chronic rhinosinusitis without nasal polyps was divided into six groups. The incidence of chronic rhinosinusitis without nasal polyps was analyzed and counted. The changes of nasal cavity structure on both sides of nasal septum deviation were observed by nasal endoscopy. Results among the 185 patients with nasal septum deviation, 129 cases were complicated with CRSs NP, the incidence rate was 69.73 and 87 cases were complicated with CRSs NP in the wide side of nasal septum deviation, the incidence rate was higher (67.4444). There were 42 cases of nasal septum deviation and narrow side complicated with CRSs NP, the incidence rate was 32.566.There was no significant difference between the sinusitis group and the control group in the direction of nasal septum deviation. The degree of nasal septum deviation was significantly different between sinusitis group and normal group. There was statistical difference between the degree of nasal septum deviation and chronic sinusitis. There was a correlation between moderate and severe nasal septum deviation and CRSs NP. The position of nasal septum deviation was statistically significant between sinusitis group and normal control group, and the high deviation of nasal septum was correlated with CRSs NP. 2. According to Lund-Mackay sinus CT evaluation and scoring method, According to the statistics of the severity of sinusitis in the patients, it was found that most of the nasal sinuses were turbidity in the broad side of nasal cavity, including maxillary sinus and anterior ethmoid sinus. 3. According to Zhang Jianning's classification of nasal septum deviation, 185 patients had nasal septum deviation. There were 129 cases of CRSs NP, of which 12 cases were complicated with CRSs NP in group A; There were 14 cases with CRSs NP in group B, 15 cases with CRSs NP in group C, 56 cases with CRSs NP in group D (high position, vertical plate of ethmoid bone), 11 cases with CRSs NP in group E and 21 cases with CRSs NP in group F. The incidence of) CRSs NP was the highest in group D F (77 cases). The results of nasal cavity examination of nasal septum deviation and CRSs NP showed that middle, inferior thyroid and uncinate process hypertrophy were more common in broad nasal cavity. Contralateral flexion and compression of middle thyroid were more common in narrow nasal cavity. Conclusion 1. The incidence of CRSs NP in patients with nasal septum deviation is higher. The incidence of CRSs NP in the wide side of nasal septum deviation is higher than that in narrow side, and the incidence of maxillary sinus in wide side of nasal septum deviation is higher than that in the wide side of nasal septum deviation, and the incidence of high deviation of nasal septum and high deviation of nasal septum is related to the occurrence of CRSs NP. The incidence of ethmoid sinus in the former group was significant. 3. The incidence of CRSs NP in the DUF group was higher. 4. The middle turbinate, inferior turbinate and uncinate process were hypertrophic in the wide side of nasal septum deviation. Contralateral flexion and compression of middle thyroid were common in narrow nasal cavity.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765
[Abstract]:Objective to investigate the relationship between nasal septum deviation and chronic rhinosinusitis without nasal polyp (chronic rhinosinusitis without nasal polyps,CRSs NP) by CT analysis of paranasal sinuses. Methods CT scanning was performed in 185 patients with nasal septum deviation. The incidence of sinusitis was evaluated by Lund-Machay CT scoring system in all cases. The incidence of nasal septum deviation in sinusitis group and normal control group was analyzed and analyzed. The side of nasal cavity which is consistent with the direction of deviation of nasal septum is called narrow side and vice versa. The incidence of sinusitis on both sides of nasal septum is analyzed. According to Zhang Jianning's grouping method, the nasal septum deviation combined with chronic rhinosinusitis without nasal polyps was divided into six groups. The incidence of chronic rhinosinusitis without nasal polyps was analyzed and counted. The changes of nasal cavity structure on both sides of nasal septum deviation were observed by nasal endoscopy. Results among the 185 patients with nasal septum deviation, 129 cases were complicated with CRSs NP, the incidence rate was 69.73 and 87 cases were complicated with CRSs NP in the wide side of nasal septum deviation, the incidence rate was higher (67.4444). There were 42 cases of nasal septum deviation and narrow side complicated with CRSs NP, the incidence rate was 32.566.There was no significant difference between the sinusitis group and the control group in the direction of nasal septum deviation. The degree of nasal septum deviation was significantly different between sinusitis group and normal group. There was statistical difference between the degree of nasal septum deviation and chronic sinusitis. There was a correlation between moderate and severe nasal septum deviation and CRSs NP. The position of nasal septum deviation was statistically significant between sinusitis group and normal control group, and the high deviation of nasal septum was correlated with CRSs NP. 2. According to Lund-Mackay sinus CT evaluation and scoring method, According to the statistics of the severity of sinusitis in the patients, it was found that most of the nasal sinuses were turbidity in the broad side of nasal cavity, including maxillary sinus and anterior ethmoid sinus. 3. According to Zhang Jianning's classification of nasal septum deviation, 185 patients had nasal septum deviation. There were 129 cases of CRSs NP, of which 12 cases were complicated with CRSs NP in group A; There were 14 cases with CRSs NP in group B, 15 cases with CRSs NP in group C, 56 cases with CRSs NP in group D (high position, vertical plate of ethmoid bone), 11 cases with CRSs NP in group E and 21 cases with CRSs NP in group F. The incidence of) CRSs NP was the highest in group D F (77 cases). The results of nasal cavity examination of nasal septum deviation and CRSs NP showed that middle, inferior thyroid and uncinate process hypertrophy were more common in broad nasal cavity. Contralateral flexion and compression of middle thyroid were more common in narrow nasal cavity. Conclusion 1. The incidence of CRSs NP in patients with nasal septum deviation is higher. The incidence of CRSs NP in the wide side of nasal septum deviation is higher than that in narrow side, and the incidence of maxillary sinus in wide side of nasal septum deviation is higher than that in the wide side of nasal septum deviation, and the incidence of high deviation of nasal septum and high deviation of nasal septum is related to the occurrence of CRSs NP. The incidence of ethmoid sinus in the former group was significant. 3. The incidence of CRSs NP in the DUF group was higher. 4. The middle turbinate, inferior turbinate and uncinate process were hypertrophic in the wide side of nasal septum deviation. Contralateral flexion and compression of middle thyroid were common in narrow nasal cavity.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765
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