【摘要】 目的 :探讨等离子技术筛前神经切断术治疗常年性变应性鼻炎 (PAR)的疗效 ,以及P物质 (SP)能神经的病理变化。方法 :用等离子治疗仪切断 4 6例 (切断组 )PAR患者鼻腔的筛前神经 ,用计分法分别评定其疗效 ,并与不切断筛前神经的 17例 (不切断组 )进行比较。同时用免疫组化方法观察切断组鼻粘膜SP能神经内P物质在治疗前后的变化 ;根据免疫组化染色呈阳性的神经纤维的面积行定量测定并与非PAR患者 (正常对照组 )进行比较。结果 :切断组计分值由治疗前的 12 .9,降为治疗后的 6 .1,其差异有显著性 (P <0 .0 1) ;而不切断组治疗前后差异无显著性。SP免疫反应 (SP IR)阳性纤维的面积在切断组治疗前与切断后之间 ,PAR患者与正常人之间的差异都具有显著性。结论 :SP在PAR的发病中确实起一定作用 ,SP IR阳性纤维在PAR患者的鼻粘膜内含量高于正常人 ,等离子切断筛前神经是治疗PAR的一种有效而简便的方法。更多还原

【Abstract】 Objective:To research the therapy effect of perennial allergic rhinitis (PAR) with anterior ethmoid neurotomy, and to observe the pathological changes of SP nerve fibres.Method:In 46 cases (neurotomy group, NG) of PAR anterior ethmoid neurotomy were performed, the surgery effect was evaluated according to the Chinese Hai Kou allergic rhinitis diagnosis and curative access standard (1997) and compared with 17 cases simulating operation without neurotomy (non neurotomy group, NNG) by clinical symptoms controlled counting scores. The substance P in nasal mucous membrane of NG was observed with immunohistochemical test, meanwhile the square of positive stained nerve fibres on the sections were measured with a quantitative analysis method after and before operation, which also were compared with that of 14 cases patients without rhinopathy (normal controlled group, NCG).Result:The average score reduced from 12.93 pre operation to 6.14 post-operation (P< 0.01 ) in NG, but in NNG there is no significant different before and after therapy. The squares of SP immune response (SP IR) positive stained fibers were significant different between pre operation and post operation in NG. The quantities of SP IR positive stained fibers in nasal mucous membrane were more in PAR patients(before operation) that that in the NCG.Conclusion:The anterior ethmoid neurotomy with plasm technique is an effective and simple therapical method for treating PAR. The SP of anterior-ethmoid nerve plays an important role in the pathological mechanism of PAR.更多还原