6例变应性真菌性鼻窦炎临床分析

Clinieal analysis of 6 cases of allergic fungal sinusitis

[背景]探讨变应性真菌性鼻窦炎(AFS)的诊断及治疗方法.[病例报告]给6例AFS患者行变应原皮肤试验,测定血清总IgE含量.在全身麻醉下行鼻内镜上颌窦自然口扩大加筛窦开放和病灶清除术,清除鼻窦病变组织后用生理盐水冲洗窦腔,彻底清除病灶.术后进行消炎及对症治疗,并口服给予强的松,鼻腔内局部给予皮质类固醇激素,对鼻窦内容物行HE染色及Gomori乌洛托品银染色.术后随访6个月以上,均未见复发.[讨论]AFS患者仍需要长期的随访和观察,AFS的诊断标准需要进一步完善.

BACKGROUND To study the methods of diagnosis and treatment in the allergic fungal sinusitis. CASE REPORTS In all 6 cases, the skin test was done and the total immunoglobulin E level was made preoperation; the surgically excised sinus mucosa and the sinus luminal debris were evaluated with HE staining and Gomori methenamine silver staining（GMS） postoperation. After endoscopic sinus surgery （ESS）, systemic and intranasal corticosteroid was individually used for two weeks and one month. All cases remained disease-free during following up 6 months after operation. DISCUSSION The patients of AFS need following up and observation with long time, the standard of the diagnosis of AFS need further completing.