不同手术方式治疗慢性鼻-鼻窦炎对上颌窦黏膜纤毛传输功能的影响

目的:比较不同手术方式治疗慢性鼻-鼻窦炎的疗效及其对上颌窦黏膜纤毛传输功能的影响,为临床制定治疗慢性鼻-鼻窦炎的优选术式提供参考依据。方法:选取2013年9月-2014年12月于本院耳鼻咽喉科就诊的160例确诊为慢性鼻-鼻窦炎的患者作为研究对象,将其随机分为4组,分别为治疗组1~4,每组各60例。治疗组1接受上颌窦自然开口扩大术,治疗组2接受上颌窦开窗术,治疗组3接受经泪前隐窝上颌窦开放术,治疗组4接受上颌窦口球囊扩张术。观察和比较4组患者的术后鼻腔黏膜的覆盖、水肿、囊泡形成、骨质暴露、瘢痕形成等情况,上颌窦窦腔内分泌物性状、蓄积情况以及术后3个月和6个月时行上颌窦腔糖精实验及窦口周黏膜活检情况。结果:四组手术后均取得较好临床疗效,而组4的临床总有效率显著高于其他三组(均P0.05)。术后3、6个月,组4Lund-Kennedy评分和MMT时间均明显低于其他三组(均P0.05);在上颌窦黏膜活检方面:术后炎性细胞数量及状细胞和黏膜下腺体细胞形态及黏膜下结构水肿改善程度亦在中组四最为显著(P0.05)。结论:上颌窦窦球囊扩张术治疗慢性鼻-鼻窦炎疗效较高,可有效改善状细胞和黏膜下腺体细胞形态及鼻窦黏膜水肿、窦口通畅引流等作用,且安全性高。

Different Surgical Treatment of Chronic Rhinitis-sinusitis the Impact on Maxillary Sinus Mucociliary Transport Function

ABSTRACT Objective: To compare the effects of different surgical treatment of chronic rhinitis - sinusitis difference, and its impact on transport function of maxillary sinus mucociliary, provide a clinical - surgical sinusitis preferably reference about the treatment of chronic nasal formulation for. Methods: From 2013.9-2014.12 , otorhinolaryngology clinic in our hospital, 160 cases were diagnosed as chronic nose - as research subjects were randomly divided into four groups of patients with sinusitis were treated from 1 to 4, 60 cases in each group; treatment group1 receiving the maxillary sinus ostium augmentation, treatment group 2 received fenestration, treatment group 3 through tears crypt before maxillary sinus surgery, treatment 4 group receiving the maxillary sinus balloon dilatation; after cover- ing the nasal mucosa observed and compared four groups of patients about edema, vesicle formation, bone exposure, scarring, etc., as well as internal maxillary sinus secretions traits, volume situation, and compared patients after four groups line maxillary sinus cavity and perioral saccharin test biopsy cases three months and six months. Results: The four groups were made after surgery better clinical effica- cy, and group efficacy 4 with the other three groups, the effect is most significant (all P <0.05), the difference was statistically significant, and after three months and six months, group 4 compared with other surgical group, the Lund-Kennedy score were also lower, MMT time were also lower, the difference was more significant (all P <0.05); in the maxillary sinus biopsy aspects: the number of postoperative in- flammatory cells and dendritic cells and glandular cell morphology and submucosal edema improved submucosal structures also in the group of four most significant (P<0.05). Conclusion: Maxillary sinus balloon dilatation treatment chronic nasal sinusitis curative effect is higher, which can effectively improve the cell and submucosal gland cell morphology and sinus mucosa edema, sinus unobstructed drainage effect, and high safety.