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題名 | 小兒慢性鼻竇炎的內視鏡手術療法=Endoscopic Sinus Surgery in Pediatric Chronic Paranasal Sinusitis |
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作者 | 黃弘孟; 李飛鵬; 劉嘉銘; 林凱南; 周俊旭; | 書刊名 | 慈濟醫學 |
卷期 | 15:1 2003.02[民92.02] |
頁次 | 頁33-36 |
分類號 | 417.6854 |
關鍵詞 | 小兒; 慢性鼻竇炎; 鼻竇內視鏡手術; Pediatric; Chronic paranasal sinusitis; Endoscopic sinus surgery; |
語文 | 中文(Chinese) |
中文摘要 | 目的:慢性鼻竇炎在臨床上,是小孩常見的疾病,而鼻竇內視鏡手術已經廣泛原使用於成人的慢性鼻竇炎的治療。我們嘗試將此手術運用於小兒慢性鼻竇炎的治療並評估其成效。病人與成效:自1993年1月至2006年6月間,於門診中經長期、積極的內科療法治療仍無效的慢性鼻竇炎小孩,計有84名;其中男性45名,女性39名,年紀介於3至16歲;我們於全身麻醉下施行鼻竇內視鏡手術,術後以Surgical及Merocel填塞傷口止血;出院後於第2、4、6週時,於鼻竇內視鏡下作追蹤治療,每名病人術後追蹤皆超過1年。結果:術後症狀改善的評估,其中鼻塞的有效改善率為89.1%,膿性鼻漏的有效改善率為87.6%;鼻黏連是最常見的合併症,84名病人皆未有嚴重的合併症發生。結論:我們認為在經麵極的內科療法失敗後的小兒慢性鼻竇炎病人,鼻竇內視鏡手術是值得一試的。 |
英文摘要 | Objective: Chronic paranasal sinusitis is a relatively common clinical disorder in children. Endoscopic sinus surgery (ESS) is widely used to treat adults with chronic paranasal sinusitis. In this article, we present our experiences with endoscopic sinus surgery in children and discuss the efficacy after operation. Patients and Methods: From January 1993 through June 2000, 84 children with chronic paranasal sinusitis received endoscopic sinus surgery after failing to respond to optimal medical treatments. There were 45 boys and 39 girls included in this study. The children ranged in age from 3 to 16 years. All of the children received endoscopic sinus urgery under general anesthesia. The post-operative sites were packed with Merocel and Surgicel. Endoscopic follow-up examinations were performed under ketamine anesthesia 2, 4 and 6 weeks after the operation, respectively. Each child was followed for more than 1 year. Results: Symptomatic improvement was assessed as being resolved, better, unchanged, and worse at 6 months after ESS. Significant improvement for each symptom was defined as the summation of those classified as resolved and better. The significant improvement rates in nasal obstruction and yellowish rhinorrhea were 89.1% and 87.6%, respectively. The most common complication was synechiae. No major complications were noted in the 84 children. Conclusion: FESS is considered appropriate for the treatment of pediatric sinusitis after optimal medical regimens have failed. |
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