摘要
目的 观察慢性鼻窦炎 (chronicsinusitis,CS)鼻内窥镜手术 (endoscopicsinussurgery ,ESS)前后鼻粘膜的组织形态及功能变化。方法 ①对 32例CS患者手术前后进行糖精试验和鼻粘膜光镜观察 ,并与健康对照组进行比较 ;②对 10例CS患者手术前后与 2例健康对照组进行鼻粘膜扫描电镜和透射电镜观察。结果 ①CS术前与对照组比较 ,糖精试验时间明显延长 (P <0 0 0 1) ;术后较术前明显缩短 (P <0 0 0 1) ;②光镜观察 :CS术前出现炎性细胞浸润、水肿、息肉形成和病理性腺体 ,与对照组比较差异有显著性 (P <0 0 1) ;术后炎性细胞浸润、水肿和息肉形成明显减轻 ,与健康对照组比较差异无显著性 (P >0 0 5 ) ;但病理性腺体术后无明显减轻 ;③电镜观察 :CS术前鼻粘膜超微结构受到破坏 ,术后 4个月后基本恢复正常。结论 本实验提示 :①CS鼻粘膜的正常结构和纤毛清除功能受到破坏 ;②ESS术后 4个月鼻粘膜的结构和纤毛清除功能较术前明显改善 ,基本恢复正常 ;③ESS术后鼻粘膜中病理性腺体的恢复可能需更长的时间。
Objectives To study morphologic and functional mucosal changes both preoperatively and postoperatively in chronic sinusitis (CS) treated with endoscopic sinus surgery (ESS). Methods 1.Saccharin test and light microscopic examination of nasal mucosa were taken preoperatively and postoperatively in 32 cases with CS and in 28 normal subjects as control. 2.Scanning and transmission electron microscopy were performed to exam preoperatively and postoperatively the nasal mucosa in 10 cases with CS and in 2 normal cases as control. Results 1.The preoper ative saccharin test time (STT) in patients with CS was significantly longer than that in the controls(P<0.001), and the postoperative STT became significantly shorter than that in preoperative one(P<0.001). 2.The pathological changes of nasal mucosa, such as infiltration in inflammatory cells, edema, polypoid formations and pathologic glands were observed preoperatively. The infiltration in inflammatory cells, edema and polypoid formations were significantly released (P<0.01) at four months after operation, and there was no significant difference comparing with the controls (P>0.05). However, the pathologic glands were not reduced even after four months postoperatively. 3.The examination of electron microscopy demonstrated that the ultrastructure of nasal mucosa was impaired preoperatively and almost completely recovered at four months postoperatively. Conclusions The normal structure and clearance function of nasal mucosa in patients with CS was impaired preoperatively, and the impaired structure and mucociliary clearing function of nasal mucosa were greatly improved after ESS and almost completely recovered at four months postoperatively. The pathologic glands and secretive function of nasal mucosa may need longer period for recovering.
出处
《中华耳鼻咽喉科杂志》
CSCD
北大核心
2001年第5期326-329,T003,共5页
Chinese Journal of Otorhinolaryngology
基金
湖南省卫生厅科研基金资助项目 ( 2 0 0 1 Y48)
