高压氧治疗在兔鼻黏膜术后转归中的作用

The effect of hyperbaric oxygen therapy on the postoperative outcome of nasal mucosa in rabbits

摘要:

目的观察兔鼻腔手术后黏膜转归过程中经高压氧治疗(hyperbaric oxygen therapy，HBOT)后的恢复情况，探讨HBOT对鼻黏膜术后愈合的促进作用。方法21只日本大耳白兔取5只为正常空白对照，余16只随机分为高压氧组和非高压氧组，每组8只，创建双侧鼻腔手术模型。高压氧组于术后第5天开始高压氧治疗，非高压氧组置于常现环境，术后第6周取全部动物双侧下鼻甲手术区黏膜观察大体形态及病理学改变。空白对照组取相同部位黏膜观察。结果大体形态：高压氧组1侧出现瘢痕增生，无粘连，2侧鼻腔内见脓性分泌物；非高压氧组7侧瘢痕粘连形成，8侧鼻腔积脓；高压氧组较非高压氧组恢复好，差异具有统计学意义（P<0.05）。病理改变示两组均见炎细胞浸润、基底膜充血水肿和纤维结缔组织增生，高压氧组表现为轻度，非高压氧组表现为中重度，差异具有统计学意义（P<0.05）。结论高压氧治疗可降低兔鼻腔手术后黏膜炎症反应，减轻基底膜充血水肿，抑制纤维结缔组织增生和瘢痕形成，促进鼻黏膜恢复。

关键词:耳鼻咽喉外科手术|鼻黏膜|高压氧|伤口愈合

Abstract:

ObjectiveTo study the promoting effect of hyperbaric oxygen therapy (HBOT) on nasal mucosa recovery after nasal surgery in rabbits.Methods21 Japanese white rabbits were randomly divided into three groups, i.e. normal blank control group (n=5), hyperbaric oxygen group (n=8) and nonhyperbaric oxygen group (n=8). The rabbits in the normal blank control group were fed under atmospheric environment, and the animals in both the hyperbaric oxygen group and nonhyperbaric oxygen group underwent operation to establish model of bilateral nasal surgery. At the fifth day after operation, the rabbits of the hyperbaric oxygen group received HBOT, while those of the nonhyperbaric oxygen group were placed in the normal environment. Gross morphological and pathological changes of nasal mucosa in the surgical area of bilateral inferior turbinate were observed at the sixth week after operation. The inferior turbinate mucosa was obtained simultaneously from the blank control group for observation.ResultsIn gross morphological examination, scar hyperplasia without adhesion presented in one side and septic secretion in 2 sides of the hyperbaric oxygen group, while scar adhesion in 7 sides and empyema in 8 sides of the nonhyperbaric oxygen group. The nasal mucosae of the hyperbaric oxygen group recovered better than those of the nonhyperbaric oxygen group, and the difference was statistically significant (P<0.05). Pathological study of nasal mucosa revealed inflammatory cell infiltration, hyperemia and edema of basal membrane as well as fiber connective tissue proliferation. However, the pathological changes in the hyperbaric oxygen group were mild while those in the nonhyperbaric oxygen group were moderatesevere, and the difference was also statistically significant (P<0.05).ConclusionBy reducing the inflammatory response, alleviating congestion and edema in the basal membrane and inhibiting the proliferation of fibrous connective tissue and scar formation, HBOT can promote the recovery of nasal mucosa after nasal surgery in rabbits.

Key words:Otorhinolaryngologic surgical procedure| Nasal mucosa| Hyperbaric oxygenation|Wound healing