儿童鼻腔鼻窦占位病变的临床研究

Clinical Study on Space Occupying Lesions in Nasal Sinus in Children

目的:探讨儿童鼻腔鼻窦占位病变的特点、诊断方法及治疗措施,为提高小儿鼻腔鼻窦占位病变治疗效果提供参考。方法:回顾性分析2011年7月-2014年7月在本院接受住院治疗的50例鼻腔鼻窦占位病变患儿临床资料,全部患儿均给予鼻内镜、影像学检查确诊病理类型及特点,针对病理类型的不同选择相应的治疗方法。结果:50例患儿均存在不同程度的鼻塞症状,17例(34.0%)鼻出血或涕中带血,7例(14.0%)面颊肿胀,5例(10.0%)面部麻木,2例(4.0%)眼球突出,2例(4.0%)张口困难,1例(2.0%)复视,1例(2.0%)牙齿松动,1例(2.0%)鼻部畸形。结论:儿童鼻腔鼻窦占位病变发病率较低,但临床误诊率也高,应综合病史、专科检查、鼻内镜及影像学手段准确诊断,明确病变部位和性质。治疗上不应沿袭成人治疗思路,应结合诊断结果,儿童生理、心理制定手术方案,以提高预后。

Objective： To investigate the features of space occupying lesions in children, the relevant diagnostic methods and treatment regimens as to make reference for the impro;cement of the therapeutic effect of treatment of space occupying lesions in children. Method： The clinical data of 50 children with space occupying lesions in nasal sinus hospitalized in our hospital for treatment from July 2011 to July 2014 was retrospectively analyzed. In order to make a definite diagnosis of the pathological types and their characteristics, all the children patients were given endoscopy and imaging examination; and different treatment regimens were chosen for the different pathological types. Result： There were 50 cases had different degree congestion symptoms, 17 cases （ 34.0% ） had nosebleed or bloody discharge, 7 cases （ 14.0% ） had buccal swelling, 5 cases （ 10.0% ） had facial numbness, 2 cases （ 4.0% ） had exophthalmos, 2 cases （ 4.0% ） had difficulty in opening mouth, 1 case （ 2.0% ） had diplopia, 1 case （ 2.0% ） had gomphiasis, 1 case （ 2.0% ） had nosal deformity. Conclusion： The incidence of space occupying lesions in nasal sinus in children is low, but the clinical misdiagnosis rate is high; in order to make a definite diagnosis of the disease and define the lesion site and nature, the combined diagnosis of the disease, including taking medical history, specialist examination, endoscopy and imaging examination into account, should be implemented, in order to improve the prognosis, the treatment thoughts for the adult patient should not be applied, and the surgical planning should involve the result of the diagnosis, physical and psychological characteristics.