慢性鼻-鼻窦炎筛窦骨质病理形态学改变及其相关因素分析  

Study for the histopathologic change of ethmoid bone in patients with chronic rhinosinusitis and its correlation factors

作　　者：唐凤珠[1] 瞿申红[1] 梁建平[1] 韦海明[2] 陆秋天[1] 周祥祯[2] 王涛[1] 张月敏[1] 

机构地区：[1]广西壮族自治区人民医院耳鼻咽喉科,南宁530021 [2]广西壮族自治区人民医院病理科

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第23期1060-1063,1067,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广西医疗卫生科研课题(No:桂卫Z2009146)

摘　　要：目的:研究慢性鼻-鼻窦炎(CRS)筛窦骨质病理形态学改变的相关因素。方法:CRS患者180例,其中Ⅰ、Ⅱ和Ⅲ型各60例,鼻内镜手术中取带有筛窦黏膜的筛骨标本送病理苏木精-伊红染色,对其病理形态学改变严重程度进行分级。统计不同临床分型其病理分级的例数及所占比率。分析筛窦骨质病理改变严重程度与筛窦黏膜病理改变程度、筛窦CT分型、病程长短及是否有手术史的关系。结果:所有患者筛窦骨质发生不同程度的病理形态学改变。病理分级:Ⅰ级5例(2.78%),Ⅱ级38例(21.11%),Ⅲ级71例(39.44%),Ⅳ级66例(36.67%)。Ⅰ、Ⅱ和Ⅲ型的筛骨病理分级结果:Ⅰ型,Ⅰ级5例(8.33%),Ⅱ级33例(55.00%),Ⅲ级15例(25.00%),Ⅳ级7例(11.67%);Ⅱ型,Ⅱ级5例(8.33%),Ⅲ级37例(61.67%),Ⅳ级18例(30.00%);Ⅲ型,Ⅲ级19例(31.67%),Ⅳ级41例(68.33%)。180例CRS患者不同临床分型、筛窦黏膜病理改变严重程度、不同筛窦CT分型、病程长短及是否有手术史与筛窦骨质病理分级均差异有统计学意义(均P<0.01)。结论:CRS筛窦骨质发生不同程度的病理形态学改变,其与临床分型、筛窦黏膜病理改变严重程度、筛窦CT分型、病程及手术史存在明显的相关性。Objective：To investigate the histopathologic changes of ethmoid bone and its correlation with clinical types of chronic rhinosinusitis（CRS）.Method：All ethmoid bones and mucosa from 180 patients with CRS after endoscopic sinus surgery were collected for histopathologic detection with HE staining.The number and the rate of cases were counted according to different histopathologic types.To analyze the correlation between ethmoid bones and clinical types of CRS,mucosal pathologic change,the CT-scanning types of sinusitis,the course of disease as well as operational history.Result：The ethmoid bone of all patients had varing degrees of histopathologic changes.There were 5 cases（2.78%） in stage Ⅰ,38 cases（21.11%） in stage Ⅱ,71 cases（39.44%） in stage Ⅲ,and 66 cases（36.67%） in stage Ⅳ.The histopathologic changs of ethmoid bone varied in different clinical types.In typeⅠ,there were 5 cases（8.33%） in stage Ⅰ,33 cases（55.00%） in stage Ⅱ,15 cases（25.00%） in stage Ⅲ,and 7 cases（11.67%） in stage Ⅳ.In type Ⅱ,there were 5 cases（8.33%） in stage Ⅱ,37 cases（61.67%） in stage Ⅲ,and 18 cases（30.00%） in stage Ⅳ.In type Ⅲ,there were 19 cases（31.67%） in stage Ⅲ,and 41 cases（68.33%） in stage Ⅳ.All histopathologic changes of ethmoid bone were statistically correlated（P0.01） with clinical types of CRS,pathologic mucosal change,the CT-scanning types of sinusitis,the course of disease as well as operational history.Conclusion：Almost all patients with CRS manifest different-degrees of histopathologic changes,which are correlated with the clinical types of CRS,pathologic mucosal change,the CT-scanning types,the course of disease as well as operational history.

关 键 词：鼻窦炎 筛骨 病理学 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]