腺样体切除术对鼻腔黏膜纤毛清除功能的影响

目的探讨腺样体切除术对鼻腔黏膜纤毛清除功能的影响。方法对2012年1月~2015年6月在我科住院行腺样体切除术(或同时行扁桃体切除术)并符合研究条件的患者89例进行总结分析。患者分为两组：A组单纯腺样体肥大者47例，B组腺样体肥大合并慢性鼻-鼻窦炎(chronic rhinosinusitis, CRS)者42例。所有患者术前及术后1个月行糖精试验以获得黏膜纤毛清除时间(mucociliary clearance time,MCT)，手术中测量鼻腔的长度后计算出黏膜纤毛清除速率(mucociliary clearance velocity, MCV)。另将35例正常儿童作为对照组，进行一次糖精试验获得纤毛清除时间。比较A、B两组患者手术前后鼻腔黏膜纤毛清除时间及清除速率，分析腺样体切除术对鼻腔黏膜纤毛清除功能的影响。结果A组患者术前及术后的MCT分别为（13.64±3.26）min，（9.04±1.78）min；B组术前及术后的MCT分别为（15.85±4.63）min，（11.90±2.70）min。A组患者术前及术后的MCV分别为（2.81±0.73）mm/min、（4.16±0.82）mm/min；B组术前及术后的MCV 分别为（2.45±0.75）mm/min、（3.35±0.83）mm/min。正常对照组的MCT及MCV分别为（7.24±2.03）min, （5.53±1.79）mm/min。两组手术前后的MCT及MCV差异具有统计学意义(P＜0.01)。结论腺样体切除术可以改善鼻腔黏膜纤毛清除功能。

Effect of adenoidectomy on nasal mucociliary clearance in children

ObjectiveTo explore the impact of adenoidectomy on nasal mucociliary clearance in children.Methods89 children (aged from 3 to 12 years old) who underwent adenoidectomy or adenotonsillectomy between 2012 and 2015 were included. The patients were divided into two groups. Patients in group one suffered from adenoid hypertrophy (AH) only (n=47), and those in group two suffered from AH accompanied with chronic rhinosinusitis (CRS)(n=42). Andersen''s saccharine test (AST) was performed to all the children before and one month after surgery. The mucociliary clearance time (MCT) was recorded. The length of nasal cavity was measured intraoperatively. Nasal mucociliary clearance velocity (MCV) (mm/min) was calculated. The preoperative and postoperative MCT and MCV were compared. In addition, 35 normal children were enrolled in control group and received AST. ResultsMCT and MCV in normal children were (7.24±2.03) min and (5.53±1.79) mm/min respectively. Pre and postoperative MCT in group one were (13.64±3.26) min and (9.04±1.78) min respectively and those in group two were (15.85±4.63) min and (11.90±2.70) min. Pre and postoperative MCV in group one were (2.81±0.73) mm/min and (4.16±0.82) mm/min, and (2.45±0.75) mm/min and (3.35±0.83) mm/min in group two. The differences of pre and postoperative parameters were all statistically significant in both groups (all P<0.01).ConclusionsImpaired nasal mucociliary clearance may play a critical role in CRS. Adenoidectomy can improve nasal mucociliary clearance in children with adenoid hypertrophy or combined with CRS.