摘要
目的探讨接触式显微内窥镜结合支撑喉镜进行喉气管检查与手术的价值。方法：①全麻下进行常规支撑喉镜检查；②应用连接好电视图像系统的接触式显微内窥镜进行全景内窥镜检查；③用１％的美兰作声带粘膜活体染色，进行接触式显微内窥镜检查；④在显微内窥镜下进行相应的喉气管显微手术。结果：接触式显微内窥镜最大放大倍数１５０倍，分辨率达到细胞水平，既可作为掌规硬管内窥镜全景检查，也可进行显微检查。能清楚地显示活体原位状态下粘膜表面上皮细胞及毛细血管的形态结构及分布排列，可直接观察到上皮细胞是否规则，核染色，核大小，核浆比率，核外形，胞核是否存在、细胞角化程度及毛细血管微循环情况等，７３例正常与异常声带表层上皮细胞及微血管存在一定的特征与差异。在支撑喉镜下应用显微内窥镜进行显微手术，图像清晰，分辨率高，视角大，手术可作得更加精细，既能彻底切除病灶，又能较好地保留正常粘膜，术后声带功能恢复良好。结论：应用接触式显微内窥镜在活体原位情况下观察粘膜上皮表层细胞及微血管的某些生理及病理改变，有助于对某些喉气管病变的诊断及治疗。在显微内窥镜下手术，可作得更加精细彻底，喉功能保存好。
Abstract Objective : For explore the values of contact microendoscopy in laryngotracheal examination and surgery. Methods :①Sustain laryngoscopy under general anesthesia. ②Panaview endoscopy by contact microendoscopy connecting with video monitor system. ③Contact microendoscopy on laryngeal mucosa epithelium previously stained with methylene blue. ④Performing laryngotracheal microsugery under the visual of contact microendo- scope. Results : With up to 150X magnification and resolution at level of cells ,the contact microendoscope can be use as panaview or microview. The epithelium and blood capillaries can be observed clearly in vivo and in situ. Sev- eral parameters : regularity of the epithelium, dimensions and color of the nucleus , nucleus-cytoplasm ratio, nucleus and cytoplasm contours , and presence of the nucleolus , mitosis , cytoplasmic inclusions , keratosis , koilocytes , and mi- cro blood vessels can be evaluated directly by means of microendoscope . Specific cellular epithelial patterns in 73 cases of different disorders were observed. Performing micro laryngeal surgeries under micro endoscope has been proved to be more perfect and more functional . Conclusions : Observing the physical and pathological varies at ep- ithelium and vessels would helpful for diagnosis and treatment in some laryngotracheal disorders. Microendoscope laryngotracheal surgeries can be performed more perfect and functional.
出处
《中国耳鼻咽喉头颈外科》
1998年第S1期31-33,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
