高压氧对兔鼻腔手术后黏膜转归影响的观察

Pathological changes of mucosa after nasal surgery in rabbits treated by hyperbaric oxygen

目的观察高压氧对兔鼻腔手术后黏膜转归的影响。方法 25只合格日本大耳白兔,随机取5只为正常对照,余20只创建双侧鼻腔手术模型,随机分为高压氧组和非高压氧组,每组10只,高压氧组术后第5天开始治疗,非高压氧组处于常压环境,术后第3周从两组中随机各取5只动物处死,术后第5周处死剩余动物取鼻腔手术区黏膜观察病理学改变,正常对照组取相同区域黏膜观察。结果术后3周两组动物黏膜均见上皮受损,纤毛紊乱短小,炎细胞浸润及固有层充血水肿,以中性粒细胞为主,少量淋巴细胞和浆细胞,高压氧治疗组呈散在或小灶性,非高压氧组呈灶性或弥漫性,并可见轻微纤维结缔组织增生;术后5周两组亦见炎细胞浸润,以淋巴细胞和浆细胞为主,少量中性粒细胞,固有层充血水肿消退,可见纤维结缔组织增生,纤毛部分恢复,两组比较,高压氧治疗组较非高压氧组恢复好。结论高压氧可减轻兔鼻腔术后黏膜炎细胞浸润、纤毛损伤和纤维结缔组织增生,促进黏膜恢复。

OBJECTIVE To observe the pathological changes of mucosa after nasal surgery with hyperbaric oxygen, and to investigate the effect of hyperbaric oxygen therapy on the recovery of nasal mucosa after nasal operation. METHODS Twenty-five healthy rabbits were randomly selected, five for normal controls, and the remaining 20 rabbits as surgery group.The rabbits in surgery group were randomly divided into hyperbaric oxygen group and non hyperbaric oxygen group, 10 rabbits in each group. Hyperbaric oxygen group began hyperbaric oxygen treatment at the fifth day after operation, the non hyperbaric oxygen group was in the atmospheric environment. After three weeks, 5 animals were randomly selected from each of the 2 groups, and the remaining animals were killed at fifth week after operation.The pathological changes of the mucosa in the nasal cavity and the operation area were observed. The same regional mucosa of the nasal cavity in the normal control group was also pathologically studied. RESULTS After 3 weeks,the epithelium of the 2 surgery groups was damaged, the cilia were become disordered and short, the inflammatory cells infiltrated and the lamina propria was congested and edematous. Neutrophils were predominant with small amounts of lymphocytes and plasma cells. The epithelium of the hyperbaric oxygen treatment group were scattered or little focal, and of the non HBO group showed focal or diffuse, and slight hyperplasia of fibrous connective tissue.At 5 weeks after operation, inflammatory cells were also found in the mucosa of 2 groups, mainly lymphocytes and plasma cells, with small amounts of neutrophils. The lamina propria hyperemia and edema disappeared in the 2 groups.Fibrous connective tissue hyperplasia was found and the cilia were partially recovered. The mucosa in the hyperbaric oxygen treatment group recovered better than that in the non hyperbaric oxygen group. CONCLUSION Hyperbaric oxygen therapy can relieve the infiltration of mucosal inflammatory cells, cilia damage and fibrous connective tissue hyperplasia after nasal cavity surgery, and promote the recovery of mucosa.