糖尿病合并急性坏死性鼻窦炎的处理

The treatment of diabetes mellitus complicated acute necrotizing sinusitis

目的探讨糖尿病合并急性坏死性鼻窦炎的处理方法。方法回顾性分析2例糖尿病合并急性坏死性鼻窦炎患者的临床处理。结果 2例患者经围术期积极控制血糖、抗感染,急诊手术开放鼻窦并清除鼻腔鼻窦坏死组织,其中1例术后第8天出院,随访至今4年余,症状无复发,现仍随访中;另1例患者因并发肾衰竭、腹水,家属于术后第3天放弃治疗,出院当日死亡。结论尽早进行围术期血糖控制、内环境稳定、手术清除坏死灶及抗感染治疗是糖尿病合并急性坏死性鼻窦炎治疗成功的关键。

Objective To investigate the treatment of diabetes mellitus complicated acute necrotizing sinusitis.Methods By way of reviewing the clinical procedures of 2patients with diabetes mellitus complicated acute necrotizing sinusitis.Results In perioperative period,by means of glycemic control,anti-infection,and emergency surgery to remove the necrotic tissue in nasal sinuses and open the sinuses,one of the patients discharged from hospital after 8days.He has been followed up for more than 4years without recurrence,and is still in follow-up.Due to complicating renal failure and ascites,the another patient gave up treatment and discharged on the third postoperative day,and died on the same day.Conclusion Glycemic control,homeostasis,surgical removal of necrotic tissue and anti-infection treatment in perioperative period as soon as possible,is the key to a successful treatment.