摘要
目的探讨慢性鼻-鼻窦炎不同类型术后黏膜功能和形态恢复情况。方法本次选取变态反应性、感染性、混合性三组准备手术的CRS患者,均为2013年1月至2014年1月收治,随机抽取变态反应性50例和感染性60例作为观察组,抽取健康志愿者30例设为正常对照组。感染性随机按感染性A、感染性B各30例划分,变态反应性30例设为C组。A、C组在出院后运用抗感染、鼻腔冲洗、鼻喷黏膜液化剂和人工合成激素等综合治疗方案,B组行抗生素应用和鼻腔冲洗治疗。结果 A、B组术腔上皮化时间无明显差异(P>0.05),A组短于C组(P<0.05)。正常对照组有平整光滑的黏膜表面,上皮细胞主要为纤毛柱状细胞,可见黏液腺体和杯状细胞,纤毛整齐直立,间质无水肿,腺体及导管无增生扩张。各实验组在术后4周黏膜炎性细胞浸润,杯状细胞增生,黏膜下腺体有明显增生及间质水肿。术腔上皮化黏膜光镜观察,各组术后4周无明显变化,A、B无差异,病理改变C组重于A组(P<0.05)。结论不同病因引发的CRS,鼻黏膜功能在术后恢复的时间不同,综合治疗情况下,变态反应引发的CRS较感染性术腔上皮化晚,观察黏膜功能,恢复情况相对较差,变态反应是对CRS手术治愈率产生影响的重要因素,感染引发的CRS,术后行抗生素应用和鼻腔冲洗即可达到理想效果。对于变应性CRS,取ATP等量合剂应用,可使黏膜纤毛清除率提高。
Objective To explore the of mucosal morphology and function recovery in different types of chronic nasal - sinusitis. Methods Selected allergic, infectious, CRS patients with mixed three groups to prepare surgery, both from January 2013 to January 2014 were treated randomly selected 50 cases of allergic and infectious as the observation group 60 cases, extraction Make healthy volunteers 30 cases of normal control group. Infection by infectious random A, B in- fection 30 cases each division, 30 cases of allergy to group C. Group A, C in the use of anti - infection after discharge, nasal wash, nasal spray mucosa liquefaction agents and synthetic hormones and other comprehensive treatment program, group B antibiotics and nasal irrigation treatment. Results GroupA, B patients epithelization time was no significant difference （P 〉 0. 05）, A group shorter than group C （ P 〈 0. 05 ）. The normal control group, the mucosal surface smooth, ciliated columnar epithelium cells mainly visible mucus glands and goblet cells, cilia neatly upright, interstitial edema, proliferative glands and ducts without expansion. In each experimental group after four weeks mucosal inflamma- tory cell infiltration, goblet cell hyperplasia, submucosal gland hyperplasia and significant interstitial edema. Surgical cavity mucosal epithelium of light microscopy, four weeks after each group had no significant change, A, B has no difference, pathological changes in group C is more important than group A （P 〈 0.05）. Conclusion CRS triggered by different causes, nasal function at different postoperative recovery time, under the combined treatment, CRS allergy - in- duced septic patients compared with late luminal epithelium of the observed mucosal function, recovery is relatively poor, allergy is important factors that affect the cure rate CRS, CRS infection triggered postoperative antibiotics and nasal irrigation can achieve the desired effect. For allergic CRS, take the same amount of adhesive applied ATP, can improve mucociliary cl
出处
《医药论坛杂志》
2016年第7期31-32,35,共3页
Journal of Medical Forum
关键词
不同类型
慢性鼻-鼻窦炎
术后
黏膜形态
功能恢复
Different types
Chronic nose - sinusitis
After
Mucosal morphology
Functional recovery
