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目的探讨鼻内镜下鼻腔扩容术综合治疗鼻源性头痛患者的疗效。方法选取2011年3月—2012年3月就诊的60例鼻源性头痛患者,其中单纯性头痛不伴鼻塞、流涕等鼻部症状者25例,头痛伴有鼻塞者25例,头痛伴鼻塞、有流脓涕者10例;头痛部位多位于前额部、鼻根部、太阳穴处及眶部,多为钝痛或头部昏沉感。所有患者均经鼻内镜检查及鼻窦冠位CT扫描检查诊断为鼻腔结构异常和(或)鼻腔、鼻窦炎性病变。根据不同病变,选择性采取相应的鼻腔扩容术,并进行术后综合治疗。术后定期随访3~12个月,参照中华医学会耳鼻咽喉科学分会、中华耳鼻咽喉科杂志编委会1997年制定的慢性鼻窦炎鼻息肉临床分型分期内镜鼻窦手术疗效评定标准评定治疗效果。结果 60例患者于术后随访3~12个月。治愈40例(66.7%),好转18例(30.0%),无效2例(3.3%),总有效率为96.7%。60例患者均未见鼻中隔穿孔、血肿、外鼻塌陷或畸形,未发生眶眼并发症、颅脑并发症等严重并发症。结论采用鼻内镜下鼻腔扩容术对于鼻源性头痛患者疗效显著,在手术成功的基础上结合综合治疗及加强术后随访是提高有效率的关键。
Objective To investigate the efficacy of nasal endoscopic nasal dilation in the treatment of nasal headache patients. Methods From March 2011 to March 2012, 60 cases of nasal headache were selected. Among them, 25 cases were simple headache without nasal congestion, runny nose and other nasal symptoms, 25 cases with headache associated with nasal obstruction, headache with nasal congestion , There are 10 cases of purulent nasal discharge; headache mostly in the forehead, nasal roots, temples and orbital, mostly dull ache or head drowsiness. All patients were diagnosed as nasal structure abnormalities and / or nasal sinusitis by nasal endoscopy and paranasal CT scan. Depending on the lesion, the corresponding selective nasal expansion surgery, and postoperative comprehensive treatment. Regular follow-up after 3 to 12 months, with reference to the Chinese Medical Association Otolaryngology Branch, Chinese Journal of Otorhinolaryngology editorial board in 1997 enacted chronic sinusitis and nasal polyps clinical staging endoscopic sinus surgery evaluation criteria to evaluate the efficacy of treatment . Results 60 patients were followed up for 3 to 12 months. Forty patients (66.7%) were cured, 18 (30.0%) were improved, 2 were ineffective (3.3%), and the total effective rate was 96.7%. None of the 60 patients had nasal septum perforation, hematoma, nasal collapse or deformity, no orbital eye complications and cranial complications. Conclusion Nasal endoscopic nasal dilatation is effective in patients with nasal headache, and the key to improving the effective rate is to combine comprehensive treatment and follow-up on the basis of successful operation.