慢性鼻-鼻窦炎患者筛窦骨质病理形态学改变与鼻内镜术中出血量的相关分析

The correlation between the volume of bleeding during endoscopic sinus surgery and the histopathologic change of ethmoid bone in patients with chronic rhinosinusitis

目的探讨慢性鼻-鼻窦炎(CRS)患者筛窦骨质病理形态学改变与鼻内镜手术中出血量、手术时间及手术并发症的相关性。方法观察CRS患者180例,在鼻内镜手术中取带有筛窦黏膜的筛骨标本送病理苏木精-伊红染色,对其病理形态学改变严重程度进行分级。分析比较筛骨病理分级与鼻内镜手术中出血量、手术时间及手术并发症的关系。结果 180例CRS患者筛窦骨质发生不同程度的病理形态学改变:Ⅰ级29例(16.11%);Ⅱ级43例(23.89%);Ⅲ级58例(32.22%);Ⅳ级50例(27.78%)。不同筛骨病理分级患者其鼻内镜手术中出血量及手术时间差异均存在显著性(P<0.01),但其手术并发症发生率差异无显著性(P>0.05)。结论 CRS患者筛窦骨质病理形态学改变的严重程度与鼻内镜手术中出血量及手术时间存在明显相关性,与手术并发症无相关性。随着筛骨病理分级增加,其术中出血量增多、手术时间延长。

【Objective】To investigate the correlation between the volume of bleeding during endoscopic sinus surgery and the histopathologic changes of ethmoid bone of patients with chronic rhinosinusitis （CRS）.【Methods】 All ethmoid bones and mucosa from 180 patients with CRS after endoscopic sinus surgery were collected for histopathologic detection with HE staining. The correlation between the different histopathologic types of ethmoid bone with the volume of bleeding during surgery, the time of surgery and the complications were compared and ana- lyzed that. 【Results】The ethmoid bone of all patients had different-degree of histopathologic changes. There were 29 cases （16.11%） in stage Ⅰ, 43 cases （23.89%） in stage Ⅱ, 58 cases （32.22%） in stage Ⅲ, and 50 cases（27.78%） in stage Ⅳ. All histopathologic changes of ethmoidal bone were statistically related （P 0.01） with the volume of bleeding during surgery and the time of surgery, but was not significantly different with the complications （P 0.05）.【Conclusion】Almost all patients with CRS indicated different degree of histopathologic changes, which was related with the volume of bleeding during surgery and the time of surgery, but was not related with the complications. The bigger histopathologic changes of ethmoid bone became, the more volume of bleeding during surgery and the longer time of surgery.