鼻甲

Nasal mucosa observation under rhinoscope: pale or grey or light purple nasal mucosa; swelling turbinate; thin or thick discharge in the nasal cavity.

鼻粘膜观察：经鼻窥镜观察见患者的下鼻甲粘膜颜色多呈苍白、淡白、灰白或淡紫色，下鼻甲多肿胀，鼻腔内多留有水样分泌物。

The available operation range in clivus and anterior cranial base by transsphenoidal opproach was also observed during the operation under the help of neuronavigational pointer. Forty-one patients underwent sublabial, transseptal, transsphenoidal approach to the pituitary region guided by Surgical Microscope Navigation was studied. The piriform aperture was 27. 2mm±3. 1 , the origin of inferior nasal concha 30mm±4. 1, the origin of middle nasal concha 27. 9mm±4. 3. These data are important for transsphenoidal approach, because the piriform aperture and the origin of both inferior and middle nasal conchas restricted the opening width of the Hardy specula. If any distance of these bony structures was much less than the mean one, may cause inadequate opening of the specula blade and resulting dissatisfied operative field. Microadenomas or cystic tumors perhaps can be operated even in a narrow exposure, but large or giant solid adenomas may need a proper evaluation including changing the operative approach or performing a bilateral submucous inferior conchotomy or posterior ethmoidectomy firstly.

手术中还利用CT导航系统观察棒研究了经口—鼻蝶窦入路在斜坡区和前颅底能够达到的实际有效操作范围，为扩大经蝶窦入路手术在斜坡区和前颅底的应用奠定基础，在国内外尚未见同类报道。41例垂体瘤患者梨状孔平均宽度27.2mm±3.1，下鼻甲根部附着处间距30mm±4.1，中鼻甲根部附着处间距27.9mm±4.3，这是经口—鼻蝶窦入路手术中，对Hardy双瓣鼻窥器张开限制的主要骨性结构，若患者这些径线值明显小于平均值，则可能因为鼻窥器打开不充分而影响手术暴露，当然对于垂体微腺瘤和以囊变为主的垂体瘤可能影响不大，但对于大和巨大垂体瘤必须要有充分的准备，包括评估是否改用其他入路，或先行鼻甲切除再行经蝶手术。

We reconstructed the 3-D and virtual endoscopy image about nasal septum, frontal area of the apertura of sphenoidal sinus, sphenopalatine foramen, sphenopalatine artery and sphenoidal sinus use Volume Rendering, Multiplanar Reformation, Virtual Endoscopy and Curved Planar Reformat, and measured and ,about undertaked The nose, nasal septum, sphenopalatine artery, anterior region of the aperture of sphenoidal sinus, sphenopalatine artery and adjacent structures of hypophysial fossa were dissected, observed, measured and analysised the dependency anatomic structure at the same time.

结果： 一、标本解剖 1、鼻孔长径11.32±0.82(10.2~13.2)mm，鼻孔短径7.85±1.21(5.2~9.8)mm。鼻中隔厚度在前、中、后部分别为5.02±0.42(3.8~5.4)mm、5.57±0.47(4.5~6.4)mm、5.55±0.55(4.8~6.4) mm。 2、鼻中隔骨与软骨交界处距前鼻棘21.26±2.47(18.1~27.6)mm，距鼻孔内侧缘中点33.72±3.52(27.1~40.6)mm，距鼻小柱30.12±2.84(26.9~36.8)mm，距蝶窦口下缘38.04±3.49(32.4~45.1)mm，距后鼻孔41.82±3.96(36.9~50.1)mm。四方软骨中部厚度、边缘厚度、前后径、上下径分别为：1.12±0.13(0.92~1.42)mm、1.28±0.24 (0.83~1.67)mm、30.93±4.52(24.9~40.6)mm、29.94±2.14(24.8~34.3)mm。 3、蝶窦口长5.64±0.39(4.92~5.94)mm，宽3.58±0.22(3.10~3.96)mm，距上鼻甲尾部9.5±0.9(8.5~12.1)mm，距上鼻道未端14.5±1.1(12.5~16.4)mm，距中鼻甲尾

In endoscopic sinus surgery with middle turbinate reserved, hypothermy plasma preserved the features and physiological functions of middle turbinate, and prevented the adhesion. So middle turbinate hypothermy plasma can improve the effect of endoscopes sinus surgery positively.

在保留中鼻甲的内窥镜鼻窦手术中，中鼻甲行等离子消融，既保留了中鼻甲的形态和生理功能，又防止术后黏连，对提高鼻内镜的疗效有积极的作用。

Objective To observe the effect of complications such as middle turbinate drift and adhesion in the treatment of middle turbinate dealtwith functional endoscopic sinus surgery.Methods In160cases dealt with FESS,to seek for what happened about the complications by resecting the lateral section and/or basilar section of middle turbinate,and keep its plate continuance by resecting the posterior ethmoid when the middle turbinate has been found to be laterotorsion,reverse,hypertrophy or vesicle change.

目的 观察实施功能性内镜鼻窦手术时，中鼻甲的处理对中鼻甲漂移、粘连并发症的影响方法在160例患者实施FESS时，对中鼻甲外翻、反向、肥、泡性改变，实施中鼻甲外侧或并游离缘部分切除，保持中鼻甲基板连续性，观察中鼻甲漂移、粘连并发症发生情况。

Methods In160cases dealt with FESS,to seek for what happened about the complications by resecting the lateral section and/or basilar section of middle turbinate,and keep its plate continuance by resecting the posterior ethmoid when the middle turbinate has been found to be laterotorsion,reverse,hypertrophy or vesicle change.

在160例患者实施FESS时，对中鼻甲外翻、反向、肥大、泡性改变，实施中鼻甲外侧或并游离缘部分切除，保持中鼻甲基板连续性，观察中鼻甲漂移、粘连并发症发生情况。

Methods: Cryogenic temperature bipolar radiofrequecy ablation-cutting operation were applied in the OSAHS patients with presence of turbinate hypertrophy in the inferior turbinate, then to observe clinical symptom、 Sleep monitoring、 prosection of inferior turbinate and Polysomnography.

对OSAHS存在下鼻甲肥大者进行下鼻甲低温射频消融术，治疗后3个月、10个月进行主观症状，下鼻甲形态大小变化、睡眠监测和气道压力滴定对照分析。

Results The time of postoperative debridement of nasal cavity in patients with partial endonasal middle turbinectomy was shorter than those with preservation of middle turbinate (P＜0.01). There was no synechia in cases with partial middle turbinectomy and 12 cases of synechia in cases with preservation of middle turbinate.

结果 ①术后鼻腔清理时间，中鼻甲部分切除侧（平均7.1 d）与中鼻甲保留侧（平均9.4 d）差异有高度显著性(t=3.84，P＜0.01)；②中鼻甲保留侧术后发生鼻腔粘连12例，中鼻甲部分切除侧无1例发生粘连；③中鼻甲部分切除侧嗅觉改善与中鼻甲保留侧差异无显著性，40例中未见嗅觉下降者。

Measure the items on before and after the two courses of treatment respectively as follows:① Syndromes Investigation: to adopt the scoring methods of symptoms and signs with the certain standard scoring table of symptoms and classifying table of signs for the patients, on the day before and after the two courses of treatment respectively ,② Signs Investigation: the mucoma visibility, swelling or hyperemia conditions, or gloyp and polypoid change in the inferior and middle nasal conchas, nasal septum, etc with a nasal endoscope on the day before and after the two courses of treatment respectively,③ Test of the lung functiaon on the previous day before and after the two courses of treatment respectively.

治疗组在治疗前、两个疗程结束后分别进行以下项目的观察：①临床症状的评定：治疗前及两个疗程结束后当天对患者鼻塞、鼻痒、流涕、喷嚏症状的程度进行评分；②体征的评定：治疗前及两个疗程结束后当天采用鼻额镜肉眼观察患者下鼻甲鼻粘膜颜色、肿胀情况，及中鼻甲是否可见，有否息肉样变等；③治疗前及两个疗程结束后即刻予以检测肺功能。

Measure the items on before and after the two courses of treatment respectively (one course for 15 days) as follows:①Syndromes Investigation: to adopt the scoring methods of symptoms and signs with the certain standard scoring table of symptoms and classifying table of signs for the patients, on the day before and after the two courses of treatment respectively,②Signs Investigation: the mucoma visibility, swelling or hyperemia conditions, or gloyp and polypoid change in the inferior and middle nasal conchas, nasal septum, etc with a nasal endoscope on the day before and after the two courses of treatment respectively,③Test of the interferon-γ、interleukine-4(IL-4) in serum of patients by the method of enzyme linked immunosorbent assay on the previous day before and after the two courses of treatment respectively.

治疗组在治疗前、两个疗程结束后分别进行以下项目的观察：①临床症状的评定：治疗前及两个疗程结束后当天对患者鼻痒、鼻塞、流涕、喷嚏症状的程度进行评分；②体征的评定：治疗前及两个疗程结束后当天采用鼻额镜肉眼观察患者下鼻甲鼻粘膜颜色、肿胀情况，及中鼻甲是否可见，有否息肉样变等；③治疗前及两个疗程结束后一天清晨空腹抽取患者肘静脉血4ml离心后，采用酶联免疫吸附试验检测患者血清IFN-γ、IL-4的含量。

On the other hand, the more important thing is because the urban housing is a kind of heterogeneity products.

另一方面，更重要的是由于城市住房是一种异质性产品。

Climate histogram is the fall that collects place measure calm value, cent serves as cross axle for a few equal interval, the area that the frequency that the value appears according to place is accumulated and becomes will be determined inside each interval, discharge the graph that rise with post, also be called histogram.

气候直方图是将所收集的降水量测定值，分为几个相等的区间作为横轴，并将各区间内所测定值依所出现的次数累积而成的面积，用柱子排起来的图形，也叫做柱状图。