慢性鼻炎下鼻甲黏膜病理及超微结构观察  

Histopathological and ultrastructural observations of inferior turbinate mucosa in chronic rhinitis

作　　者：董晶[1,2] 曹建国[1,2] 金杰[1,2] 刘慧茹[1,2] 徐永昌[1,2] 冯志伟[1,2] 钱海峰[1,2] 朱平[3] 

机构地区：[1]同济大学附属杨浦医院 [2]上海市杨浦区中心医院耳鼻咽喉头颈外科,上海200090 [3]上海交通大学医学院细胞生物学教研室,上海200025

出　　处：《中国耳鼻咽喉颅底外科杂志》2014年第1期28-32,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨慢性鼻炎下鼻甲黏膜组织病理及超微结构特征性改变。方法收集38例慢性鼻炎病例标本,其中慢性单纯性鼻炎12例;慢性肥厚性鼻炎26例,其中6例行下鼻甲手术。每例患者分别切取下鼻甲黏膜2块依次送病理及超微结构检查。结果病理及超微结构显示下鼻甲黏膜上皮不同程度脱落、间质炎细胞浸润、纤毛结构不同程度缺损等共同特点。慢性单纯性鼻炎间质腺体增生,血管扩张,炎细胞浸润,伴急性炎症者可见中性粒细胞;慢性肥厚性鼻炎间质以淋巴细胞和浆细胞浸润为主,黏膜上皮脱落化生,间质纤维增生;下鼻甲黏膜下手术患者纤毛结构保护较好。结论慢性单纯性鼻炎和慢性肥厚性鼻炎有不同特征性组织病理及超微结构所见,下鼻甲黏膜下手术是治疗慢性肥厚性鼻炎理想手术方式。Objective To investigate the histopathological and ultrastructural characteristics of the inferior turbinate mucosa in chronic rhinitis. Methods 38 cases of chronic rhinitis were included in this study. Of them, 12 cases were chronic simple rhinitis （CSR） and 26 cases were chronic hypertrophic rhinitis （CHR）. 6 cases of CHR were treated surgically. Mucosa specimens of the inferior turbinate were obtained from all cases and observed histopathologically and electron microscopically. Results Histopathologic and electron microscopic examinations of CSR and CHR specimens demonstrated some common characteristics including mucous epithelium defulvium, inflammatory cell infiltration in stroma and uhrastructural defect of mucosal cilia to different degrees. Meanwhile, CSR and CHR showed special histopathologic and electron microscopic characteristics separately. In CSR, gland proliferation, blood vessel dilatation and inflammatory cell infiltration could be observed. CSR accompanied with acute inflammation demonstrated neutrophil infiltration in stroma. CHR showed infiltration of lymphocyte and plasma cell, mucous epithelium defulvium and stroma fibroplasia. The study also showed well protection of uhrastructures of inferior turbinate mucosal cilia via submucous approaches of inferior turbinate resection. Conclusions CSR and CHR demonstrate different pathological changes and ultrastructural characteristics. Surgical treatment of inferior turbinate via submucous approach is an ideal method for CHR.

关 键 词：慢性鼻炎 病理学 超微结构 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]