鼻中隔成形术与鼻中隔鼻成形术术后黏膜纤毛清除功能的变化及比较。

文献信息

中文摘要

目的： 鼻腔黏膜纤毛清除（MCC）是上呼吸道的一种生理机制，可清除局部产生的沉积物、过多分泌物和不需要的吸入颗粒。已知多种病理状态，如鼻炎、鼻窦炎、鼻中隔偏曲、鼻息肉和下鼻甲肥大，会通过引起鼻阻塞而降低黏膜纤毛机制的活性。黏液分泌增加伴纤毛运动受损会阻碍鼻腔分泌物的清除，并使患者易发生反复感染。本研究旨在确定常进行的鼻腔手术如何影响黏膜纤毛清除。
方法： 研究纳入43例接受鼻中隔成形术的患者和34例接受开放式鼻中隔鼻成形术的患者。对两组在年龄、性别、吸烟状况和MCC评分方面进行统计学比较。
结果： 两组在术后早期（第一周）均表现出MCC暂时性延长。在第三个月时，鼻中隔成形术组的MCC值显著改善（p<0.05）。开放式鼻中隔鼻成形术组的改善较慢，且第三个月时MCC值仍高于鼻中隔成形术组（p<0.001）。
结论： 鼻中隔成形术对MCC机制有积极影响。我们的结果提示，在开放式鼻中隔鼻成形术中，抬高和手术时间延长可能对MCC产生负面影响，并持续至术后第三个月。

英文摘要

OBJECTIVES: Nasal mucociliary clearance (MCC) is a physiological mechanism of the upper respiratory tract that removes locally produced deposits, excess secretions, and unwanted inhaled particles. Various pathologies, such as rhinitis, sinusitis, septal deviation, nasal polyposis, and inferior turbinate hypertrophy, are known to reduce the activity of the mucociliary mechanism by causing nasal obstruction. Increased mucus secretion accompanied by impaired ciliary movement prevents the clearance of nasal secretions and predisposes patients to recurrent infections. The aim of this study was to determine how commonly performed nasal surgeries affect mucociliary clearance.
METHODS: The study included 43 patients who underwent septoplasty and 34 patients who underwent open-technique septorhinoplasty. The two groups were statistically compared in terms of age, sex, smoking status, and MCC scores.
RESULTS: Both groups demonstrated a temporary prolongation of MCC in the early postoperative period (first week). At the third month, MCC values improved significantly in the septoplasty group (p<0.05). Improvement was slower in the open-technique septorhinoplasty group, and MCC values remained higher at the third month than in the septoplasty group (p<0.001).
CONCLUSION: Septoplasty has positive effects on the MCC mechanism. Our results suggest that elevation and prolonged operative time may have a negative effect on MCC that persists until the third postoperative month in open-technique septorhinoplasty.