老年鼻中隔偏曲和窦口鼻道复合体解剖变异与慢性鼻窦炎关系的研究

Correlation between chronic sinusitis and deflection of nasal septum and anatomical variation of ostiomeatal complex in elderly patients

目的探讨老年鼻中隔偏曲和窦口鼻道复合体(OMC)解剖变异与慢性鼻窦炎的关系。方法分析2005年1月—2013年1月在本院接受治疗的60例老年慢性鼻窦炎患者的临床资料并设为观察组;另选取非慢性鼻窦炎患者60例设为对照组。结果 25例额窦鼻窦炎患者中,高位偏曲显著高于低位偏曲(χ2=4.000,P=0.046);观察组中鼻甲气化发生率显著高于对照组(χ2=15.810,P<0.001);观察组钩突偏曲发生率显著高于对照组(χ2=5.657,P=0.017);观察组钩突肥大发生率显著高于对照组(χ2=4.630,P=0.031);观察组鼻丘气房发生率显著高于对照组(χ2=5.192,P=0.023)。Logistic回归分析显示,高位鼻中隔偏曲、中鼻甲气化、钩突偏曲、钩突肥大及鼻丘气房是导致鼻部解剖变异者发生慢性鼻窦炎的独立风险因素。结论鼻中隔偏曲及OMC解剖变异在慢性鼻窦炎患者中有一定的发生率,但并非所有解剖变异患者均会致病。高位鼻中隔偏曲、中鼻甲气化、钩突偏曲、钩突肥大及鼻丘气房是导致鼻部解剖变异者发生慢性鼻窦炎的独立风险因素,可针对性地进行干预。

Objective To explore the correlation between of chronic sinusitis and deflection of nasal septum and anatomical variation of ostiomeatal complex（OMC）in elderly patients. Methods Clinical materials of 60 elderly patients with chronic sinusitis were analyzed and designed as observation. Another 60 patients without chronic sinusitis were designed as control group. Results In the patients with sinusitis of frontal sinus, the ratio of patients with superior deflection was significantly larger than thatof patientswith lower deflection. The incidence rate of turbinate gasification in the observation group was significantly higher than that in the control group（χ 2= 15.810,P 0.001）. The incidence rates of uncinate process deviation, hypertrophic uncinate process and agger nasi cell in the observation group were significantly higher than those in the control group.Logistic analysis showed that superior deflection, turbinate gasification, uncinate process deviation,hypertrophic uncinate process and agger nasi cell were the independent risk factors of chronic sinusitis in patients with OMC. Conclusion There is a certain incidence rate of deflection of nasal septum and anatomical variation of OMC in patients with chronic sinusitis, but not all of patients with OMC will develop into certain disease. Because superior deflection, turbinate gasification, uncinate process deviation, hypertrophic uncinate process and agger nasi cell are the independent risk factors of chronic sinusitis in patients with OMC, the targeted intervention measures can be implemented for treatment of patients with nasal disease.