Nghiên cứu tổng quan đặc điểm lâm sàng, cận lâm sàng viêm mũi xoang do nấm dị ứng

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Tác giả: Bảo Linh Trần, Thị Thu Hằng Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 616.21 *Diseases of nose, nasopharynx, paranasal sinuses, larynx

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý: 114-117

Bộ sưu tập: Metadata

ID: 502324

Thêm vào giỏ

Mô tả tổng hợp đặc điểm lâm sàng và cận lâm sàng viêm mũi xoang do nấm dị ứng. Đối tượng và phương pháp: Tổng quan luận điểm: các bài báo, các nghiên cứu, bài giảng, sách giáo khoa tại 3 cơ sở dữ liệu Pubmed, Google Scholar, Sciencedirect đạt các tiêu chí nghiên cứu. Kết quả: Tìm được 1012 tài liệu. Sau khi phân tích, 17 bài báo được đưa vào nghiên cứu: nghiên cứu sử dụng thiết kế hồi cứu 58,8% (10), nghiên cứu tiến cứu 41,1% (7) và cỡ mẫu của các nghiên cứu dưới 50 người (100%). Độ tuổi trung bình của những người tham gia dưới 35 tuổi 64,7%, tỷ lệ nam/nữ: 1,24/1 .Bệnh nhân có các triệu chứng chảy mũi, ngạt tắc mũi, polyp 100% (157)
rối loạn ngửi 38,2% (60), đau đầu 18,4% (29)
chảy mũi sau17,1% (27). Trên phim chụp CLVT: Polyp 100% (157). Tăng tỷ trọng giữa đám mờ đồng nhất 57,3% (57,3). Xói mòn xương 18,4% (29 và mở rộng về hướng nội sọ, hốc mắt 15,9% (25). Tỷ lệ soi tươi thấy nấm là 25,4 %, cấy nấm (+) là 62,5%. Trong đó: nấm Aspergillus 45,2% (71), nấm Bipolaris 5,7% (9), nấm Alternaria 5,7% (9) các nấm khác (Rhizomucor, Fusarium sp..) 5,7% (9). Chỉ số bạch cầu ái toan máu >
1 G/L là 39,5% và igE máu (toàn phần và đặc hiệu) >
600UI/mL là 46,5%. Test da (+) với dị nguyên nấm gặp với tỷ lệ 19,7%. Kết luận: Viêm mũi xoang do nấm dị ứng có biểu hiện tắc mũi, chảy nước mũi và rối loạn ngửi. Chụp CLVT có hình ảnh polyp, tăng tỷ trọng giữa đám mờ đồng nhất, và xói mòn xương. Họ nấm gây bệnh phổ biến nhất là nấm Aspergillus, tiếp đó là nấm Bipolaris và nấm Alternaria, các loại khác ít gặp, thường có chỉ số bạch cầu ái toan máu và igE tăng cao.Synthetic description of clinical and paraclinical characteristics of allergic fungal sinusitis. Subjects and methods: Scoping Review: articles, studies, lectures, textbooks at 3 databases Pubmed, Google Scholar, Sciencedirect met the research criteria. Result: Found 1012 documents. After analysis, 17 articles were included in the study: the study used a retrospective design of 58.8% (10), a prospective study of 41.1% (7) and the sample size of the studies was less than 50. people (100%). The average age of the participants was under 35 years old 64.7%, male/female ratio 1.24:1.Patients had symptoms of runny nose, stuffy nose, polyp 100% (157)
smell disorder 38.2% (60), headache 18.4% (29)
postnasal drip17.1% (27). On CT scan: 100% polyp (157). Increased density between uniform blurs 57.3% (57.3). Bone erosion 18.4% (29 and intracranial and orbital enlargement 15.9% (25) The rate of fungal examination on fresh examination is 25.4%, fungal culture (+) is 62.5%. Of which: Aspergillus 45.2% (71), Bipolaris 5.7% (9), Alternaria 5.7% (9) other fungi (Rhizomucor, Fusarium sp..) 5.7% (9). Blood eosinophils >
1 G/L is 39.5% and blood igE (whole and specific) >
600 UI/mL is 46.5% Skin test (+) with fungal allergens is found at a rate of 19, 7% Conclusion: Allergic fungal rhinosinusitis with nasal obstruction, rhinorrhea, and smell disturbance CT scan showed polyps, increased density between homogeneous opacities, and bone erosion. The most common pathogens are Aspergillus, followed by Bipolaris and Alternaria, other less common species often have elevated blood eosinophils and igE.

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