慢性鼻及鼻窦炎患者筛窦骨质病理形态学改变与手术预后的相关性研究

目的探讨慢性鼻及鼻窦炎(chronic rhinosinusitis,CRS)患者筛窦骨质病理形态学改变与鼻内镜术预后的相关性。方法观察CRS患者200例,术中取筛骨标本送病理检查,用HE染色观察筛窦骨质的病理形态学改变。采用Biedlingmaier等的分级方法 ,对筛骨病理学改变程度分级。术后随访半年。结果筛窦骨质病理形态学改变:I级31例(15.50%),II级42例(21.00%),III级70例(35.00%),IV级57例(28.50%)。不同筛骨病理分级患者鼻内镜术后的疗效、术腔上皮化时间、术后鼻内镜Lund-Kennedy评分及鼻腔鼻窦结局测试-20(SNOT-20)量表分值存在统计学差异。结论 CRS患者筛窦骨质病理学改变的程度与鼻内镜术后疗效、上皮化时间、Lund-Kennedy评分及健康相关生活质量相关,随筛骨病理分级增加,其疗效越差,术腔上皮化时间越晚,鼻内镜Lund-Kennedy评分越高,术腔恢复越差,SNOT-20分值越高。

Study for the correlation between post-surgical prognosis and the histopathologic change of ethmoid bone in patients with chronic rhinosinusitis

OBJECTIVE To investigate the correlation between the postoperative prognosis and the histopathologic changes of ethmoid bone in patients with chronic rhinosinusitis（CRS）.METHODS All ethmoid bones and mucosa from 200 patients with CRS after endoscopic sinus surgery were collected for histopathologic detection with HE staining.Patients were followed up for six monthes.RESULTS The ethmoid bone of all patients have different degree of histopathologic changes.There were 31 cases（15.50%）in stage I,42 cases（21.00%）in stage II,70 cases（35.00%）in stage III,and 57 cases（28.50%） in stage IV.All histopathologic changes of ethmoidal bone are statistically correlative with the curative effect,the time of epithelization,the grade of Lund-Kennedy,and the quality of life.CONCLUSION Almost all patients with CRS indicated different degree of histopathologic changes,which are correlative with the curative effect,the time of epithelization,the Lund-Kennedy endoscopy scores,and the quality of life.The heavier histopathologic changs of ethmoid bone,the lower rate of theraputic effect and the later time of epithelization.The higher grade of Lund-Kennedy endoscopy,the higher score of of SNOT-20.