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目的 从病理学角度来阐明表面活性物质对降低咽鼓管表面张力的作用及在治疗分泌性中耳炎中的作用。方法 将已制成分泌性中耳炎的豚鼠分成二组 ,各组 12只 ,分别用表面活性物质和地塞米松注入鼓室治疗 ,并以常规光镜、电镜程序制作标本 ,观察咽鼓管粘膜上皮的超微结构的改变。结果 发现二组在病理方面有显著的差异 ,表面活性物质治疗组咽鼓管粘膜上皮的纤毛微绒毛病变轻 ,纤毛表面可见稀薄的粘液毯 ,而地塞米松治疗组咽鼓管粘膜上皮的纤毛断裂、脱落或“细胞糜烂”等。结论 表面活性物质有保护咽鼓管粘膜上皮的作用 ,其机理主要是表面活性物质可降低纤毛粘液毯的表面张力 ,防止管壁粘着 ,有助于分泌物的排出。
Objective To elucidate the role of surfactant in reducing the surface tension of eustachian tubes and its role in the treatment of secretory otitis media from the perspective of pathology. Methods Guinea pigs with secretory otitis media were divided into two groups, 12 in each group. The animals were infused with tympanum with surfactant and dexamethasone, respectively. The guinea pigs were made by routine light and electron microscopy. Changes in ultrastructure. The results showed that there was a significant difference between the two groups in the pathology. In the surfactant-treated group, the ciliated epithelium had less ciliated microvilli, thin viscous mucilage on the cilia surface, and ciliated mucosal epithelial cilia in the dexamethasone treated group Broken, shedding or “cell erosion” and so on. Conclusion Surfactant has protective effect on eustachian mucosa epithelium. The main mechanism is that surfactant can reduce the surface tension of mucilaginous mucoid blanket and prevent the adhesion of tube wall, which is helpful to excretion discharge.