鼻中隔偏曲患者双侧下鼻甲的影像学和病理学观察  

Image and pathology characteristics of the inferior turbinate at two sides in patients with deviated nasal septum

作　　者：黄咏梅[1] 李娜[2] 乔秀军[1] 李祥昭[1] 曹汉海[1] 

机构地区：[1]日照市人民医院耳鼻咽喉科,山东日照276826 [2]青岛大学医学院附属医院耳鼻咽喉-头颈外科,山东青岛266011

出　　处：《山东大学耳鼻喉眼学报》2006年第5期420-422,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的:观察鼻中隔偏曲患者双侧下鼻甲的形态结构及其黏膜的病理改变。方法:为住院行手术治疗鼻中隔偏曲患者30例行术前鼻窦冠状位CT扫描,在CT片上直接测量下鼻甲的宽度和高度,将测量数值根据CT片上的标尺换算成实际值。手术全麻后、鼻腔表麻前,在鼻内镜下,于鼻中隔明显偏曲处对称切取下鼻甲组织,在光镜、透射电镜下观察下鼻甲的黏膜上皮层及固有层组织结构的改变。结果:从30例鼻中隔偏曲患者的鼻窦CT中观察到,偏曲对侧下鼻甲的高度和宽度均大于同侧,差别有统计学意义。光镜结果:偏曲对侧下鼻甲较同侧黏膜上皮、基底膜增厚,血管增生,纤维组织增生,腺体密度同侧较对侧减小。电镜结果:偏曲对侧较同侧的下鼻甲黏膜固有层的结缔组织胶原纤维增生明显;黏膜固有层毛细血管及腺体周围毛细血管的内膜具有窗格样空隙,小静脉内皮基底膜变透明,间隙增大,肿胀样,结构疏松。结论:在鼻中隔偏曲患者中,偏曲两侧的下鼻甲在宽度和高度上差异有统计学意义。偏曲对侧下鼻甲的肥大,既有骨质增生的成分,也有黏膜及黏膜下层组织增生的因素。Objective： To observe the changes of shape, structure and mucosa of two sides inferior turbinate in patients with deviated nasal septum. Methods： Operation for redressing the nasal septum deviation was performed in 30 patients with deviated nasal septum. Nasal sinus coronal CT was taken before operation, and then the slice optimally displayed the ostiomeatal complex was singled out. The height and the width of inferior turbinate were measured. The mucosa samples of inferior turbinate were taken from the site where the nasal septum deviation was most obvious. The pathological performance of mucosa samples was observed under optical microscope and transmission electron microscope. Results： From the nasal sinus CT, the difference of the width and the height of inferior turbinate between two sides of nose in patients with nasal septum deviation was significant （P 〈 0.01）. Result of optic microscope： compared with resuits from the other side, the mucosa epithelium of the inferior turbinate in the opposite side of deviation had characteristics of proliferation and hypertrophy, the basal lamina of incrassation, the blood vessel of proliferation and dilatation in mesenchyma, the cavity of blood vessel of more circuitous, the fibre tissue of obvious proliferation and the density of gland of small. The number of inflammation cell in two sides was not significantly different. Result of transmission electron microscope： compared with the other side, the mueosa of the inferior turbinate in the opposite side of deviation, and the collagenous fibers in the lamina propria were obvious proliferated. Fenestrated capillary was seen under the subepithelia vascular layers and around the gland. The basal lamian of small vein was limpid, swelled, loosened and the space increased. Conclusions： The difference of the width and the height of inferior turbinate between two sides of nasal in the patients with nasal septum deviation is significant, which may contribute to the hypertrophy of inferior turbinate in the opposite

关 键 词：鼻中隔 下鼻甲 影像学 病理学 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]