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Conception and early diagnosis and treatment of chronic invasive fungal rhinosinusitis
Author(s): 
Pages: 370-373
Year: Issue:  5
Journal: CHINESE JOURNAL OF OTORHINOLARYNGOLOGY

Keyword:  真菌鼻窦炎诊断内窥镜检查治疗;
Abstract: 目的探讨慢性侵袭性真菌性鼻-鼻窦炎(chronic invasive fungal rhinosinusitis,CIFRS)的概念、早期诊断与治疗.方法以最终病理学诊断为依据,总结分析48例真菌性鼻-鼻窦炎(fungal rhinosinusitis,FRS)的病程、临床表现、鼻窦CT、窦内病变特征、窦黏膜表现、组织病理学和真菌学特征、以及2种治疗方式的疗效.结果 18例为CIFRS,早期在病程、临床表现、真菌种类和鼻窦CT特征与非侵袭型真菌性鼻窦炎(noninvasive fungal rhinosinusitis, NIFRS)相似;其中16例(88.9%)窦内病变为泥石样物,15例(83.3%)窦黏膜表现为Ⅲ度以上;窦内病变为泥石样物、同时窦黏膜Ⅲ度以上者与病理真菌的符合率为83.3%(15/18);鼻窦清创术加抗真菌药物治疗治愈率达81.8%.结论CIFRS进展缓慢,临床并非少见,早期临床表现缺乏特异性,窦内为泥石样物和窦黏膜表现为Ⅲ度以上是其主要鉴别特征,早期诊断和鼻窦清创术联合抗真菌药物治疗可望提高治愈率.
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