鼻内结构正常化手术治疗鼻源性头痛的临床分析.pdfVIP

中国实用医药2oo8年7月第3卷第2O期 China Prac Med。Jul2oo8，V01．3。No．20 · 23· 鼻内结构正常化手术治疗鼻源性头痛的 临床分析 田崇明 桂长俊 张树平 姚兰刚 张友良 【摘要】 目的 探讨鼻内结构正常化手术治疗鼻源性头痛的疗效。方法 对160例鼻源性头痛患 者实施在鼻内镜下矫正鼻内解剖异常 ，去除鼻腔、鼻窦内病变组织，开放病变窦口，使鼻中隔居中，维持 中下鼻甲的形态，使鼻窦炎症消退。结果 术后随访3—24个月，该组治愈97例，占60．6％(97／160)， 显效40例，占25．0％(4o／16o)，有效l8例，占11．3％(18／160)，临床总有效率96．9％，无效5例。结论 鼻源性头痛由鼻腔、鼻窦的解剖异常或疾病引起，鼻内镜下鼻内结构正常化手术，视野清晰明亮，操作 准确，彻底切除病灶，使鼻内结构恢复正常，治疗效果良好，具有重要的临床应用价值。 【关键词】 鼻内镜；鼻源性头痛；鼻内结构正常化手术 Clinical analysis of intranasal structure·normalizing surgery in treating rhinogenic headache TIAN Clwng—ming，GUI Chang-jun，ZHANG Shu-ping，et a1．Xinhua Hospital of Huainan，Huainan，Anhui 232052，China 【Abstract】 Objective To study the efficacy of intranasal structure-normalizing surgery in treating rhi- nogenic headache．Methods 160 patients were treated with endoscopic intranasal structure—norm alizing surger- Y，cleared the lesions tissue innasal cavity and sinus，opened the sinus ostium，corrected anatomic abnormali~， reconstructed nasal septal and middle turbinate and inferior turbinate，dissipated sinusitis．Results Followed up survey 3—24 months postoperatively．97 cases were cured．The cure rate of 160 cases was 60．6％ ．40cases were obviously recovered(25．0％)．18 cases were EFFECTIVELY recovered(11．3％)．The clinical cure rate WaS 96．9％．5 cases did not recover．Conclusion Rhinogenic headache was caused by anatomic abnormali~or disease．Endoscopic intranasal structure—normalizing surgery can accurately and clearly clear the ill tissue and have the normal nasal structure and have good therapeutic effect and impo~ant clinical value． 【Key words】 Endoscopic sinus；Rhinogenic headache；Intranasal structure—normalizing surgery 头痛是临床上常见的症状，原因很多，机理也很复杂，鼻 鼻道复合体病变者，全部采用，Messerklinger术式” ，即常规切除 源性头痛则为鼻腔、鼻窦的解剖异常或疾病而引起，是产生头 钩突，切除肥大筛泡，对于肥大或气化的中鼻甲行中鼻甲前下或 痛的常见原因之一。近年来我院采用鼻内镜下鼻内结构正常 外侧部分切除或中鼻甲成形术；对于中鼻甲反向弯曲，使中鼻甲 化手术治疗鼻源性头痛，疗效满意。现报告如下。