中药复方对鼻窦炎伴息肉术后上颌窦口黏膜恢复的影响

作者	单位
熊志洁	湖北省宜昌市第一人民医院耳鼻喉科湖北443000
章松勤	湖北省宜昌市第一人民医院耳鼻喉科湖北443000
方荣	湖北省宜昌市第一人民医院耳鼻喉科湖北443000

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中文摘要:

目的观察中药复方制剂冲洗内窥镜鼻窦手术(endoscopicsinussurgery,ESS)后术腔,对黏膜恢复的作用。方法78例(140侧)均为本科行ESS的慢性鼻窦炎伴鼻息肉患者。试验组40例(70侧)术后每天用中药制剂冲洗鼻腔,对照组38例(70侧)不使用。两组分别于ESS术后2~3、8~11、13~15周钳取上颌窦开口后壁的黏膜组织进行观察。结果内镜下试验组在ESS术后2~3、8~11、13~15周,黏稠涕、黏膜水肿肥厚、窦口堵塞、窦内血性分泌物、粘连等项目与对照组比较,侧次差异均有显著性(P<0·05,P<0·01);光镜下试验组鳞状上皮化生、纤维组织增生等指标与对照组比较,侧次差异亦有显著性(P<0·05)。电镜下试验组炎性细胞浸润、纤维减少排列紊乱、微绒毛和短纤毛等指标与对照组比较,侧次差异有显著性(P<0·01)。结论中药制剂用于ESS术后冲洗鼻腔,可加快促进术腔黏膜恢复,安全易于操作。

英文摘要:

ObjectiveTo observe the action of Chinese herbal preparation (CHP) on the recovery of nasal sinus mucosa after endoscopic sinus surgery (ESS). MethodsSeventy-eight patients (140 sinus) with chronic nasosinusitis and nasal polyps, who had undergone ESS, were divided into two groups. The 40 patients (70 sinuses) in the experiment group were treated with daily nasal flushing with diluted CHP while the 38 patients (70 sinuses) in the control group were untreated. Tissues of nasal mucosa were taken out from patients’ posterior walls of maxillary sinus at different time points, i.e. 2-3 weeks, 8-11 weeks and 13-15 weeks after ESS were observed. ResultsSignificant difference was shown between the two groups under endoscope at all the time points in occurrence (patient/sinus) of sticky mucus, swelling and thickened mucus, occlusion of sinus opening, bloody secretion in sinus, and adhesion, etc. (<0.05, PWT<0.01). Light microscopic examination showed significant difference between the two groups in occurrence (patient/sinus) of squamous epithelial metaplasia and fiber tissues proliferation (<0.05). And electron microscopic examination also showed significant difference between the two groups in occurrence (patient/sinus) of inflammatory cell infiltration, fibers decrease, disordered arrangement, microvilli and short cilia (<0.01). ConclusionUsing CHP for postoperative nasal flushing after ESS is a safe and manageable approach with effects in promoting nasal mucosa recovery.

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