功能性鼻内镜术后鼻黏膜变化及其临床意义  

Patho-physiological changes of mucosa after functional endoscopic sinus surgery and their clinical implications

作　　者：刘俊卿[1] 赵海亮[1] 刘淑芳[1] 

机构地区：[1]山西医科大学第二医院,山西太原030001

出　　处：《临床医药实践》2007年第12期1128-1130,共3页Proceeding of Clinical Medicine

摘　　要：目的:观察功能性鼻内镜术(FESS)后鼻黏膜变化,为完善治疗、提高手术治愈率提供科学的依据。方法:采用M esserk linger术式治疗慢性鼻窦炎、鼻息肉患者83例,分别于FESS术后1个月和4个月取其前筛区黏膜标本;以鼻中隔偏曲患者(既往无鼻窦炎病史)作为对照,光镜观察以及检测鼻黏膜纤毛清除速率(MTR)。结果:光镜观察:FESS术后1个月前筛区黏膜上皮有67例为鳞-柱交界上皮,16例为假复层柱状纤毛上皮;术后4个月前筛区黏膜83例基本恢复为假复层柱状纤毛上皮。鼻黏膜纤毛清除速率:FESS术后1个月与4个月比较、FESS术后1个月与正常对照组比较M TR之间差异均有显著性(P<0.05),FESS术后4个月与正常对照组间无显著差异。结论:鼻内镜术后鼻黏膜可以再生,术后4个月黏膜基本恢复为假复层柱状纤毛上皮;术后4个月M TR恢复正常。Objective:To study the patho-physiological changes of mucosa after functional endoscopic sinus surgery and to provide objective support for cure rate′s enhance.Methods:Mucosa samples were taken at 1 and 4 months after FESS from 83 cases with chronic sinusitis and from case of nasal septum deviation,and examined by light microscopy.Saccharin test was also performed on these cases.Results:One month after FESS,67 cases showed squamous-columnar epithelium,and 16 cases had pseudo stratified ciliated columnar epithelium,while all cases had pseudostratified ciliated columnar epithelium 4 months after FESS.Mucociliary transport rates(MTR) in patients at one month were significantly longer than that in patients at 4 months after FESS.There was no significant difference of MTR between controls and patients at 4 months after surgery.Conclusion:The ethmoid mucosa can regenerate after the FESS,all cases had pseudostratified ciliated columnar epithelium 4 months after FESS.

关 键 词：功能性鼻内镜术 黏膜纤毛清除速率 鼻黏膜 鼻窦炎 鼻息肉 

分 类 号：R765[医药卫生—耳鼻咽喉科]