鼻窦灌注液冲洗对慢性鼻窦炎鼻内镜术后的疗效机制研究

Mechanisms for the Curative Effect of Douching with the Nasal Sinuses Perfusate in Treating Chronic Sinusitis after Endoscopic Sinus Surgery

目的探讨鼻窦灌注液冲洗对慢性鼻窦炎鼻内镜术后的疗效机制。方法行鼻内镜手术的100例慢性鼻窦炎患者,随机分为治疗组和对照组,各50例。观察两组内镜术后炎性黏膜纤毛传输功能、辅助T(Thl/Th2)细胞因子及嗜酸粒细胞(EOS)的水平。结果治疗后3个月,治疗组和对照组患者治疗后的纤毛传输功能、组织中Th1/Th2细胞因子的表达均较治疗前有显著提高(P<0.01);两组治疗后γ-干扰素(IFN-γ)、白介素4(IL-4)水平比较,差异均有统计学意义(P<0.05);两组治疗后EOS的水平比较,差异有统计学意义(P<0.05)。结论术腔冲洗是慢性鼻窦炎鼻内镜术后综合处理中的关键措施,能有效促进术腔黏膜纤毛超微结构和功能的恢复;能有效地减轻炎症反应,消除黏膜水肿,恢复其自身保护和防御功能。

Objective To explore the mechanisms for the curative effect of douching with the nasal sinuses perfusate in treating chronic sinusitis after endoscopic sinus surgery. Methods A total of 1130 chronic sinusitis patients after endoscopic sinus surgery were randomly divided into the treatment group and the control group （50 cases each）. Inflammatory mucosa cilia function, helperT lymphocyte （Thl/Th2） factor levels and acidophilus granulocyte （EOS） levels were observed in both groups. Results After 3 months of treatment,mucociliary transport rate（MTR） and expression of Th//Th2 cytokines notably increased（P 〈0. O1 ） ; gamma - interferon （ IFN - gamma） levels, interleukin - 4 （ IL - 4 ） levels, and EOS levels also increased significantly （ P 〈 O. 05 ）. Conclusion Douching with the nasal sinuses perfusate is a key countermeasure after the endoscopic sinus surgery treatment of chronic sinusitis which promotes the rehabilitation of both the ultrastructural structure and the clearance function of the mueosa cilia. It effectively reduces inflammation and eliminate mueosa edema, which in turn restores the defence function of the mucosa.