本文選題：鼻中隔穿孔 + 鼻中隔軟骨部��； 參考：《廣西醫(yī)科大學》2010年碩士論文

【摘要】： 目的：通過對鼻中隔穿孔發(fā)生的原因和部位進行分析,探討與鼻中隔穿孔發(fā)生的有關因素,以及鼻中隔穿孔的原因和部位關系,為臨床實踐中預防鼻中隔穿孔的發(fā)生提供依據(jù)。 方法：對57例經廣西醫(yī)科大學耳鼻咽喉頭頸外科確診的鼻中隔穿孔患者的臨床資料進行回顧性分析,包括穿孔的發(fā)生原因、部位、大小、性別及年齡等并進行相關分析。 結果：在鼻中隔穿孔的發(fā)生原因中,行Killian氏鼻中隔矯正術后發(fā)生穿孔30例,惡性腫瘤化療后穿孔5例,其他原因如特殊炎癥、鼻腔治療后引起穿孔(梅毒、天花、炎癥等)5例,腫瘤侵犯引起穿孔2例,外傷后引起穿孔2例,鼻腔異物引起穿孔2例,鼻腔填塞后引起穿孔1例,原發(fā)性穿孔7例。穿孔部位位于鼻中隔軟骨部47例,骨部10例；按穿孔直徑大小將鼻中隔穿孔分3度：直徑小于0.5cm為小穿孔,0.5～1.5cm為中度穿孔,大于1.5cm為大穿孔,在本組病例中,小穿孔14例,中度穿孔15例,大穿孔28例。經卡方分析,不同部位穿孔原因的構成有差異性,將穿孔原因進行兩兩比較(檢驗水準為0.002), Killian氏鼻中隔術后穿孔占總穿孔例數(shù)的比例與其他原因穿孔占總穿孔例數(shù)的比例的差別均有統(tǒng)計學意義(P=0.000),而其他原因引起穿孔占總穿孔例數(shù)的比例之間的差別均無統(tǒng)計學意義。對穿孔原因與部位進行卡方分析,發(fā)現(xiàn)Killian氏鼻中隔矯正術后穿孔、化療后穿孔、腫瘤侵犯致穿孔均與穿孔部位有相關性,P值分別為0.049、0.033和0.028, Killian氏鼻中隔矯正術后發(fā)生穿孔多位于軟骨部,化療后穿孔多位于骨部,腫瘤侵犯致穿孔多位于骨部；鼻中隔穿孔原因和部位均與穿孔大小、性別、年齡的統(tǒng)計學分析無相關性。 結論：Killian氏鼻中隔矯正術是導致鼻中隔穿孔的主要原因；其穿孔部位多位于軟骨部。鼻中隔穿孔原因和部位均與穿孔大小、性別、年齡無相關性。
[Abstract]:Objective: to analyze the causes and location of nasal septum perforation, to explore the related factors of nasal septal perforation, as well as the relationship between the causes and location of nasal septal perforation, so as to provide the basis for the prevention of nasal septal perforation in clinical practice.Methods: the clinical data of 57 patients with perforation of nasal septum confirmed by otolaryngology and head and neck surgery of Guangxi Medical University were analyzed retrospectively, including the cause, location, size, sex and age of perforation.Results: among the causes of nasal septum perforation, there were 30 cases of perforation after Killian's correction of nasal septum, 5 cases of malignant tumor perforation after chemotherapy, other reasons such as special inflammation, 5 cases of perforation (syphilis, smallpox, inflammation, etc.) after nasal cavity treatment.There were 2 cases of perforation caused by tumor invasion, 2 cases of perforation caused by trauma, 2 cases of perforation caused by foreign body in nasal cavity, 1 case of perforation caused by nasal packing, and 7 cases of primary perforation.According to the size of perforation diameter, the perforation of nasal septum was divided into three degrees: the diameter less than 0.5cm was 0.5 ~ 1.5cm, the diameter of small perforation was 0.5 ~ 1.5cm, and the diameter of 1.5cm was large perforation. In this group, 14 cases were small perforation.There were 15 cases of moderate perforation and 28 cases of large perforation.By chi-square analysis, the causes of perforation in different parts are different.Comparing the causes of perforation (test level: 0.002), the ratio of perforation to total perforation after Killian's nasal septum operation is statistically different from the proportion of perforation to total perforation due to other causes.There was no significant difference in the proportion of perforations to the total number of perforations.The causes and location of perforation were analyzed by chi-square analysis. It was found that Killian's nasal septum was perforated after orthopedic surgery and perforation after chemotherapy.Perforation caused by tumor invasion was correlated with the location of perforation (P = 0.049, 0.033 and 0.028, respectively). Perforation after Killian's nasal septum orthopedic surgery was mostly located in cartilage, perforation after chemotherapy was in bone, and perforation caused by tumor invasion was mostly located in bone.The cause and location of nasal septum perforation were not correlated with the size, sex and age of perforation.Conclusion the main cause of nasal septum perforation is the correction of the nasal septum by Wechillian's surgery, and most of the perforations are located in the cartilage.The cause and location of nasal septum perforation were not correlated with the size, sex and age of perforation.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R765

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