黄莉,金晶,钟明航,胡举迪,汪煜婕,谢天宏

• 1:遵义医科大学附属医院耳鼻咽喉科

摘要(Abstract)：

目的:探讨鼻中隔穿孔发生的独立危险因素，总结临床发病特征，为预防与诊疗提供依据。方法:回顾性纳入遵义医科大学附属医院耳鼻咽喉科2018年1月至2025年12月收治的56例鼻中隔穿孔患者为观察组，同期1∶1匹配鼻中隔结构完整、伴鼻部症状者56例为对照组。收集基线资料、生活习惯、既往史及鼻腔用药史，采用χ~2检验行单因素分析，差异有统计学意义的变量纳入多因素二元logistic回归模型，筛选独立危险因素。结果单因素分析显示，年龄≥50岁、吸烟史、鼻部外伤史、鼻中隔手术史、慢性鼻炎/鼻窦炎病史、长期使用鼻用血管收缩剂、糖尿病病史、长期挖鼻史与鼻中隔穿孔相关(均P<0.05)。多因素分析显示，鼻中隔手术史(OR=5.126,95%CI 2.179～12.068)、鼻部外伤史(OR=4.283,95%CI 1.865～9.847)、慢性鼻炎/鼻窦炎病史(OR=3.752,95%CI 1.621～8.687)、吸烟史(OR=3.109,95%CI 1.357～7.128)、长期使用鼻用血管收缩剂(OR=2.449,95%CI 1.065～5.628)为独立危险因素(均P<0.05);长期挖鼻史为潜在危险因素(OR=2.105,95%CI 0.981～4.452,P=0.062)。结论:鼻中隔手术损伤、鼻部外伤、慢性鼻腔炎症、长期吸烟、鼻用血管收缩剂滥用是鼻中隔穿孔的主要独立危险因素，临床上需针对高危因素开展个体化防控，规范手术操作与鼻腔用药，避免长期挖鼻，降低鼻中隔穿孔发生率。

关键词(KeyWords)： 鼻中隔穿孔;独立危险因素;鼻黏膜损伤;鼻部外伤;慢性鼻窦炎

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 黄莉,金晶,钟明航,胡举迪,汪煜婕,谢天宏

DOI: 10.13201/j.issn.2096-7993.2026.10.003

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