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目的:探讨辐射对豚鼠鼻黏膜结构及微血管的损伤。方法:选择健康豚鼠84只,随机分为对照组(12只)及照射组(72只)。均在同样条件下喂养。将照射组豚鼠置于直线加速器射线内照射,每周1次,每次照射5Gy,计3周,总剂量15Gy,建立辐射损伤动物模型。分别于照射后0.5、1.0、2.0、3.0、5.0、6.0个月处死动物12只,随机取6只做鼻腔黏膜微血管铸型,另6只做病理检查。对照组在假照射后6个月处死动物,随机各选6只分别做鼻黏膜微血管铸型检查和病理检查。结果:照射组豚鼠的鼻黏膜辐射后早期表现为急性炎症反应,黏膜大量坏死、脱落,电镜下见仅少部分黏膜表面还被覆着正常的纤毛结构。以后黏膜开始修复,至6个月时基本结束,但大部分黏膜失去了正常的纤毛柱状上皮结构特点,部分区域甚至代为组织转化的鳞状上皮;微血管铸型可见,早期改变为毛细血管扩张充血及血管内皮细胞肿胀,以后逐渐出现毛细血管的扭曲变形、闭塞及中断,毛细血管数量大量减少,致血液回流障碍,微静脉萎瘪。后期部分区域出现新生的毛细血管,但结构紊乱,不具备微循环的功能。结论:鼻黏膜的损伤、晚期的鳞状上皮组织转化以及鼻黏膜微循环的破坏是放疗后鼻腔功能障碍的病理学基础。
Objective: To investigate the radiation damage to the nasal mucosa and the microvascular in guinea pigs. Methods: 84 healthy guinea pigs were randomly divided into control group (12 rats) and irradiation group (72 rats). Feeding in the same conditions. The irradiation guinea pigs were placed in the linear accelerator ray irradiation, once a week, each irradiation 5Gy, total 3 weeks, the total dose of 15Gy, the establishment of radiation injury animal model. Twelve animals were sacrificed at 0.5, 1.0, 2.0, 3.0, 5.0 and 6.0 months after irradiation respectively. Six of them were randomly selected for nasal mucosal microvascular casting and the other six were examined by pathology. Animals in the control group were sacrificed 6 months after the fake irradiation, and 6 rats were randomly selected for nasal mucosal microvascular cast examination and pathological examination. Results: The nasal mucosa of irradiated guinea pigs showed acute inflammatory reaction in the early stage. Mucosal necrosis and shedding occurred. Only a few mucosal surfaces were covered with normal cilia structure under electron microscope. Mucosa began to repair, to 6 months basically ended, but most of the mucosa lost the normal cilia columnar epithelial structural features, and even part of the area on behalf of tissue-transformed squamous epithelium; microvascular cast visible early changes to telangiectasia congestion And vascular endothelial cell swelling, the gradual emergence of capillary distortions, occlusions and interruptions, a substantial reduction in the number of capillaries, resulting in blood flow disorders, venous wilting. Newborn capillaries appear in some areas in the later period, but the structure is disorderly and does not have the function of microcirculation. Conclusion: The damage of nasal mucosa, the transformation of advanced squamous epithelium and the damage of nasal mucosa microcirculation are the pathological basis of nasal dysfunction after radiotherapy.