内镜鼻窦术后合理的局部用药对上颌窦粘膜形态学影响的观察  

Effect of proper local medication on morphology of maxillary sinus mucosa after endoscopic sinus surgery

作　　者：蒋腊梅[1] 肖健云[2] 刘季威[2] 

机构地区：[1]湖南师范大学医学院耳鼻咽喉科教研室,湖南长沙410006 [2]中南大学湘雅医院耳鼻咽喉科,湖南长沙410008

出　　处：《中国耳鼻咽喉颅底外科杂志》2002年第2期91-93,I001,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的 探讨内镜术后局部用药对上颌窦粘膜的作用。方法 运用光镜和电镜观察了4组上颌窦药物灌注后窦口周围粘膜组织学的变化。结果 治疗前窦口周围粘膜上皮糜烂、脱落、萎缩变薄,表面纤毛大部脱落,细胞间连接松散,线粒体减少、肿胀。治疗后敏感抗生素组上皮细胞修复用,排列规则,连接紧密,纤毛再生,长短、粗细均匀、致密,胞内线粒体增多,其内嵴增多;而非敏感抗生素组及生理盐水对照组未见上皮修复。结论 慢性鼻窦炎内镜术后,应采用敏感抗生素抗感染及皮质激素药物抗变态反应,对术后鼻窦粘膜的功能恢复非常重要。ve To investigate the effect of local medication on maxillary sinus after the surgery. Methods The histological changes of maxillary sinus mucosa were checked under optical and electronic microscopes after 4 groups of drugs were injected into the maxillary sinus cavity. Results Before the treatment the mucosa epithelium around the maxillary sinus became erosed, defluxed, atrophied and thinner. Cillia reduced largely. Cells queued loosely and vacuoles appeared between them. Mitochondrions decreased in number and swelled. After the sensitive antibiotics treatment, epithelial cells restored, queueing regularly and tightly. Cillia regenerated, growing densely and almost in the same shape. Mitochondrions and their cristae inside increased. While after the nonsensitive antibiotics and normal saline contrast treatment,there was no sign of any restoration of epithelium. Conclusion We should use sensitive antibiotics against infection andsteroid medicine against metamorphosis after functional endoscopic sinus surgery. This is very important for the functional restoration of the sinus mucosa.

关 键 词：鼻窦内镜术 鼻窦炎 外科学 鼻窦粘膜 解剖学 组织学 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]