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目的:通过分析单侧鼻窦病变患者的临床特征,探讨单侧鼻窦病变的发病规律。方法:对2 480例鼻窦病变患者的临床资料进行统计学分析,并针对部分鼻窦病变类型进行讨论。结果:1 350例(54.4%)双侧鼻窦病变患者的术后病理诊断均为普通的慢性鼻窦炎。1 130例(45.6%)单侧鼻窦病变患者中术后病理提示为慢性鼻窦炎者589例(52.1%),其余541例(47.9%)患者中真菌性鼻窦炎312例(27.6%),内翻性乳头状瘤95例(8.4%),鼻窦囊肿78例(6.9%),恶性肿瘤34例(3.0%),骨瘤及骨纤维异常增生症11例(1%),其他11例(1%)。单侧鼻窦病变中真菌性鼻窦炎患者呈现逐年增多趋势,头面部胀痛(46.8%)、涕血及鼻出血(31.1%)为其常见症状(P<0.05)。内翻性乳头状瘤近几年多见,男性好发(77.9%),32.6%的患者存在同侧鼻窦手术史,影像学检查可见窦壁骨质吸收破坏(26.7%)。恶性肿瘤患者约半数为老年人,男性多见(79.4%),涕血及鼻出血(58.8%)为其常见症状(P<0.05),影像学可见窦壁骨质吸收破坏(35.3%)。结论:单侧鼻窦病变患者有近半数为非普通炎症性疾病,其中真菌性鼻窦炎及内翻性乳头状瘤、骨瘤、鳞状细胞癌等各种良恶性肿瘤的发生率较高。因此对于这类患者应进行详尽的病史询问,仔细的内镜检查、影像学检查,以免漏诊、误诊。
Objective: To analyze the clinical features of patients with unilateral sinuses to explore the pathogenesis of unilateral sinuses. Methods: The clinical data of 2 480 cases of sinus diseases were analyzed statistically, and some types of sinus lesions were discussed. Results: The postoperative pathological diagnosis of 13 350 patients (54.4%) with bilateral sinus lesions were all common chronic sinusitis. Postoperative pathology was found in 589 (52.1%) of the 130 patients (45.6%) with unilateral sinusitis and in 312 (27.6%) of the remaining 541 (47.9%) patients with fungal sinusitis There were 95 (8.4%) cases of inverted papilloma, 78 (6.9%) sinus cysts, 34 (3.0%) malignant tumors, 11 osteosarcoma and bone fibrous dysplasia %). Patients with fungal sinusitis in unilateral sinus lesions showed a trend of increasing year by year with head and face pain (46.8%), nasal discharge and nasal hemorrhage (31.1%) as common symptoms (P <0.05). Inverted papilloma more common in recent years, men with good hair (77.9%), 32.6% of patients with ipsilateral sinus surgery, imaging examination showed sinusoidal bone destruction (26.7%). Approximately half of the patients with malignant tumors were elderly, 79.4% were male, and 82.8% were nasal discharge and epistaxis (P <0.05). Image damage of the sinus wall was found in 35.3% of cases. CONCLUSION: Nearly half of unilateral sinus diseases are non-common inflammatory diseases. Among them, fungal sinusitis, inverted papilloma, osteoma and squamous cell carcinoma have a high incidence of various benign and malignant tumors. Therefore, for such patients should be detailed medical history, careful endoscopy, imaging examination, so as to avoid misdiagnosis.