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題名 | YAMIK鼻竇導管治療鼻竇炎--初步報告=YAMIK Sinus Catheter for Treatment of Sinusitis--Preliminary Report |
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作 者 | 鄭元凱; 劉嘉銘; 林嘉德; | 書刊名 | 中華民國耳鼻喉科醫學雜誌 |
卷期 | 34:2 民88.03-04 |
頁次 | 頁99-104 |
分類號 | 416.854 |
關鍵詞 | YAMIK鼻竇導管; Proetz鼻竇置換法; 鼻竇口鼻道綜合體; YAMIK sinus catheter; Proetz displacement method; Ostiomeatal complex; |
語文 | 中文(Chinese) |
中文摘要 | 背景:慢性或復發性鼻竇炎的治療常是臨床上相當棘手的問題,除了持續性的局 部治療如鼻部沖洗或作上頜竇穿刺之外,只有鼻竇手術一途。但前者在沖洗時藥物能進入鼻 竇內的量極低;用穿刺則只作用在上頜竇,對其他鼻竇幾乎無效。YAMIK 鼻竇導管由俄國醫 師 Kozlov 等所發明,乃是利用 Proetz 鼻竇置換法的原理讓藥物直接注入所有鼻竇內來治 療鼻竇炎,本科以 Kozlov 贈予之鼻竇導管進行臨床試驗來證實其效果及施行的適應症。 方法: 從 1996 年 7 月至 1997 年 6 月將此導管應用於 15 名鼻竇炎患者, 於局部 cocaine 棉條麻醉以下 gentamicin (2 mg/ml) 進行 YAMIK 導管鼻竇沖洗,每週 1 次,每 人平均接受 4.6 次的治療,然後再作症狀及影像學檢查評估。 結果:症狀方面,所有患者皆認為在第 1 次鼻竇沖洗後雖仍有鼻涕, 但並不黏稠,且較容 易擤出;影像學檢查則以上頜竇的改善較為明顯,尤其是將積液排出,但黏膜肥厚仍存在。 其次為前篩竇,但鼻竇口鼻道綜合體則仍呈阻塞狀態。 結論:YAMIK 鼻竇導管雖不能治瘉慢性鼻竇炎,但是對於急性及復發性鼻竇炎效果不錯,有 慢性鼻竇炎者,若不想接受手術治療或不適合手術者,則此治療法不但可以減少藥物的使用 亦可達到比傳統保守療法更好的效果,而且對於較輕微的鼻竇炎患者是否需要手術治療,可 以作更審慎的評估。 |
英文摘要 | Background: The YAMIK sinus catheter method, which was developed in Russia, is a modification of the Proetz displacement method for the treatment of sinusitis. In this study, we tried to elucidate the effectiveness and the role of the YAMK sinus catheter. Mehods: From July 1996 to June 1997, fifteen patients with paranasal sinusitis were enrolled. For each patient a YAMIK sinus catheter was used for displacement irrigation therapy once weekly for 3 to 6 consecutive weeks. Oral antibiotic was only prescribed during the first week. The relief of symptoms and the improvement based on imaging studies were evaluated. Results: Nasal secretions significantly decreased during the treatment period. Notably, on CT scan, clear-up of the sirus was noted in 81.8% of the diseased maxillary sinuses. Conclusions: Displacement irrigation through the YAMIk sinus catheter is a promising treatment of sinusitis in an out-patient setting. It is also a quick, noninvasive and effective method to measure the function of the sinus ostium. Furthermore, to assess the feasibility of further surgical intervention, it is very useful. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。