迟发性鼻中隔脓肿病因及治疗方法探讨

Discussion on the etiology and treatment of late-onset nasal septal abscess

目的探讨迟发性鼻中隔脓肿的病因及治疗方法。方法选取近6年我院收治的18例迟发性鼻中隔脓肿患者,发病诱因分别为:鼻出血经微波治疗后并发鼻中隔脓肿9例;鼻内镜手术(鼻中隔矫正术、鼻息肉切除术)术后并发鼻中隔脓肿4例;鼻外伤鼻中隔骨折并发鼻中隔脓肿3例;无明显诱因出现鼻中隔脓肿3例。其中,9例患者采取鼻中隔脓肿切开引流术;9例患者行鼻内镜下鼻中隔脓肿清理术。结果微波治疗鼻出血致迟发性鼻中隔脓肿占发病诱因的50%;鼻内镜下脓肿清理术鼻部症状改善时间、平均住院时间、术后复发等均优于脓肿切开术。结论鼻出血微波电凝止血及鼻内镜手术是迟发性鼻中隔脓肿发病主要诱因。在治疗原发病基础上,行鼻内镜下鼻中隔脓肿清除术更能取得良好疗效。

Objective：Discuss on the etiology and treatment of late-onset nasal septal abscess.Methods：Select 18 cases of last 6 years in our hospital of patients with late-onset nasal septal abscess.whose predisposing factors are：9 0f them with nasal septal bscess after microwave therapy on epistaxis;4 0f them with nasal septal abscess after endoscopic surgery（correction of nasal septum,nasal polyps resection）;3 0f them with nasal septal abscess after the traumatic fractures of nasal septum;3 0f them are no apparent cause appears nasal septal abscess.And,9 cases of patients with incision and drainage of abscess of nasal septum;9 cases of patients undergoing endoscopic nasal septal abscess debridement. Results：Nsal septal abscess after microwave therapy on epistaxis make up 50% of Predisposing factors;endoscopic nasal septal abscess debridement improve postoperative recurrence in time.the average length of stay,postoperative recurrence are superior to the incision and drainage of abscess of nasal septum.Conclusions：Microwave therapy on epistaxis and nasal endoscopic surgery are main incentives of late-onset nasal septal abscess;based on the treatment of the primary disease,endoscopic nasal septal abscess debridement can achieve good effect.