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目的检测慢性鼻窦炎鼻内镜手术术前和术后鼻黏膜结构及功能差异,探讨鼻黏膜在慢性鼻窦炎鼻内镜术后愈合过程中的意义。方法对2006年12月至2011年1月间开展鼻内窥镜鼻窦手术治疗109例慢性鼻窦炎患者进行疗效分析。结果内窥镜鼻窦手术术前和术后糖精试验纤毛传输速率分别为(3.91±1.16)mm/min和(7.27±1.74)mm/min,手术前后比较,差异有统计学意义(P<0.01)。术前纤毛柱状细胞减少,粗细不等、相互粘连、排列紊乱、纤毛融合,杯状细胞增多,桥粒连接不清,内质网扩张,细胞间连接疏松,线粒体空泡变,核形不规则,间隙增宽。术后细胞间隙仍较宽,但形态基本正常,纤毛数目增加,并见短纤毛和微绒毛,纤毛粗细较均匀,排列较整齐、密集,可见“9+2”结构,内质网及线粒体结构正常。结论慢性鼻窦炎患者内窥镜鼻窦手术术前及术后鼻黏膜形态及功能发生了显著变化。
Objective To detect the differences of nasal mucosa structure and function before and after endoscopic sinus surgery in patients with chronic sinusitis and to explore the significance of nasal mucosa in the healing process after endoscopic sinus surgery for chronic sinusitis. Methods The clinical data of 109 cases of chronic sinusitis treated by endoscopic sinus surgery between December 2006 and January 2011 were analyzed. Results The preoperative and postoperative saccharin transmission rates of endoscopic sinus surgery were (3.91 ± 1.16) mm / min and (7.27 ± 1.74) mm / min, respectively. The difference was statistically significant before and after operation (P <0.01) . Preoperative cilia columnar cells decreased, ranging in thickness, adhesion, disorder, cilia fusion, goblet cells increased, desmosomal connection is not clear, endoplasmic reticulum expansion, loose cell connections, mitochondrial vacuolar changes, nuclear irregular , The gap widens. After surgery, the cell gap was still wide, but the morphology was basically normal. The number of cilia increased, and the number of cilia and microvilli increased. The cilia were more uniform and arranged neatly and densely. The structures of “9 + 2”, endoplasmic reticulum Mitochondrial structure is normal. Conclusion The morphology and function of nasal mucosa in patients with chronic sinusitis before and after endoscopic sinus surgery have significant changes.