摘要
目的:探讨慢性鼻窦炎鼻息肉鼻内镜术后术腔上皮阶段性修复的特点及规律,为改进鼻内镜术后处理措施提供依据.方法:对20例慢性鼻窦炎鼻息肉患者,在鼻内镜术后7～14 d取筛窦外侧壁、筛窦顶及上颌窦口处囊泡组织,分别进行光、电镜观察.结果:①内镜下见囊泡呈灰白色或淡黄色,半透明,有的含有囊液,有的为实质性.②光镜下见16例囊泡上皮为假复层纤毛柱状上皮,2例为复层鳞状上皮,2例在假复层纤毛柱状上皮中有节断性鳞状上皮组织转化;固有层水肿,上皮层及上皮下层有多量炎性细胞浸润,上皮下可见黏液腺、混合腺及其导管;小血管扩张充血.③电镜下见上皮为假复层纤毛柱状上皮,纤毛排列尚整齐,其间有微绒毛.多数纤毛横断面可见9+2型微管结构,有些中心微管缺如,有些仅有1个中心微管.上皮细胞中高尔基复合体发达,内质网扩张,线粒体多数呈明显凝集变性,有的线粒体呈1～2度肿胀,溶酶体增多.上皮内可见炎性细胞浸润,多数为中性粒细胞及淋巴细胞,也可见嗜酸粒细胞及浆细胞.结论:囊泡是鼻内镜术后术腔上皮再生反应活跃的表现,是术腔上皮化过程中的一个早期不平衡的再生过程,提示术后囊泡是类似鼻息肉组织病理学改变的早期局限性、病理性修复的现象.清除这种失衡的上皮化组织--囊泡,能有效遏制鼻息肉复发,使术腔上皮化均衡展开.
Objective：To research the restoration characteristics of epithelia in nasal cavity and nasal sinuses with chronic sinusitis and nasal polyps after endoscopic sinus surgery ,and to provide basis for improving the treatment after operation. Method：Twenty patients with chronic sinusitis and nasal polyps after endoscopic sinus surgery were observed. The “Vesicle tissues” situated ostiomeatal complex （OMC） were observed with light and transmission electron microscopy after operation of 7-14 days. Result： ① The “Vesicle tissues” were offwhite or buff, some contained liquid,and some were parenchyma under the endoscopy. ② The epithelia of “Vesicle tissues” were pseudostratified ciliated columnar epithelium（16/20）, and some were stratified squamous epithelium（2/20 ）, some were squamous metaplasia in pseudostratified ciliated columnar epithelium（2/20）. Lamina propria were edema. Inflammation cells infiltrated epithelial lining and subepithelial lining. We found mucous gland, mixed gland and glangular duct under subepithelial lining,and small vascular ectasia under light microscopy.③ Transmission electron microscope： epithelia were pseudostratified ciliated columnar epithelium, cilia were in good order , microvilli located between cilia. The cross section of majority cilia were 9＋ 2 form microtubule, but in some cilia we could not find microtubule and could only find one central microtubule. Golgi complex were upgrowth,and endoplasmic reticulum expand,and multi mitochondrion were coagulation degeneration in epithelial cells. Some mitochondrion were 1-2 degree swelling and the lysosome increased. Inflammation cells infiltrated epithelial lining. Majority were neutrophil and lymphocyte, but we also found eosinophil and plasmacyte. Conclusion： “Vesicle tissues” is the manifestation of active epithelia regeneration in nasal cavity and nasal sinuses after endoscopic sinus surgery, it＇s the earlier period of imbalance regeneration of the epithelization in postoperative cavity. �
出处
《临床耳鼻咽喉科杂志》
CAS
CSCD
北大核心
2005年第20期923-925,共3页
Journal of Clinical Otorhinolaryngology
关键词
鼻窦炎
鼻息肉
内镜术
超微结构
病理学
Sinusitis ~ Nasal polyps ~ Endoscopic ~ Ultrostructure ~ Pathology
