158例非侵袭性真菌性鼻窦炎的临床分析

Clinical analysis of 158 cases of non-invasive fungal sinusitis

目的分析非侵袭性真菌性鼻窦炎的临床特点、影像学特征、治疗方法及预后。方法收集郑州大学第一附属医院2019年10月至2021年10月收治的158例非侵袭性真菌性鼻窦炎患者的临床资料,所有患者均行鼻内镜手术,经病理明确真菌感染,术后给予规范化药物治疗及鼻内镜检查随访。结果非侵袭性真菌性鼻窦炎主要侵犯上颌窦(67.72%)、蝶窦(23.42%),以头痛(61.39%)、鼻塞(41.77%)为主要临床表现,鼻窦CT主要表现为软组织影内可见钙化点,病理可见真菌菌丝,鼻内镜手术是目前主要的治疗方法。结论非侵袭性真菌性鼻窦炎临床症状不典型,诊断依据影像学检查及病理结果,鼻内镜手术可以彻底治疗,预后好,复发率不高。

Objective To analyze the clinical features,imaging features,treatment methods and curative effects of non-invasive fungal sinusitis.Methods Clinical data of 158 patients with fungal sinusitis admitted to the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were collected.All the patients had complete data.Nasal endoscopic surgery were underwent,non-invasive fungal inflammation were confirmed by pathology,standardized drug treatment were performed after surgery,and follow-up were preceded by nasal endoscopic examination.Results Non-invasive fungal sinusitis mainly invaded maxillary sinus(67.72%)and sphenoid sinus(23.42%),and the main clinical manifestations were headache(61.39%)and nasal congestion(41.77%).The main CT manifestations were calcification in soft tissue and fungal mycelia in pathology.Functional nasal endoscopic surgery was the main treatment method at present.Conclusions The clinical symptoms of non-invasive fungal sinusitis are not typical.The diagnosis is based on the imaging and pathological findings.Nasal endoscopic surgery can be completely sufficient with good prognosis and low recurrence rate.