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目的探讨鼻、鼻窦术后顽固性非阻塞性鼻塞的原因及处理、防治方法。方法对10例鼻、鼻窦术后3个月以上仍主诉顽固性鼻塞,检查见鼻腔通畅患者,行鼻内镜检查及依次予0.01%肾上腺素溶液、复方薄荷油滴鼻液、1%丁卡因喷鼻,观察鼻塞变化。根据检查结果及曾经接受的治疗的详细经过,分析鼻塞原因。结果 1例证实为下鼻甲与中鼻甲接触,将鼻腔压迫感误以为“鼻塞”;6例系下鼻甲前后端同时接受黏膜毁损性治疗导致鼻腔感觉功能降低;2例系神经心理因素为主的主观性鼻塞;1例可能为鼻腔隐蔽部位压迫或肿胀感误认为“鼻塞”。结论下鼻甲前后端同时接受黏膜毁损性治疗,导致鼻腔感觉减退,是术后顽固性鼻塞的重要原因,术中应尽量避免。
Objective To investigate the causes, treatment, prevention and treatment of intractable non-obstructive nasal obstruction after nasal and sinus surgery. Methods 10 cases of nasal and sinus surgery more than 3 months after the main complaint of intractable nasal obstruction, see the nasal patency patients underwent endoscopic examination and followed by 0.01% epinephrine solution, peppermint oil nasal drops, 1% Dinka Due to nasal spray, observe changes in nasal congestion. According to the results of the examination and the treatment has been accepted in detail after the analysis of the causes of nasal congestion. Results 1 case confirmed inferior turbinate and middle turbinate contact, the nasal cavity pressure was mistaken for “nasal congestion”; 6 cases of inferior turbinate before and after mucosal injury treatment led to nasal sensory function decreased; 2 cases of neuropsychological factors The main subjective nasal obstruction; 1 case may be concealed nasal pressure oppression or swelling mistaken for “nasal congestion.” Conclusions Both the anterior and posterior turbinate of the inferior turbinate receive mucosal destructive treatment at the same time, leading to the decrease of nasal sensation. It is an important cause of postoperative intraoperative refractory nasal obstruction and should be avoided in the operation.