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作者企图通过289份中耳渗出液生化及组织学的研究,提出渗出性中耳炎病理生理的设想。测定项目有:微量粘度测定、涂片Wrights染色、总蛋白量、葡萄糖、酸性磷酸酶、鹼性磷酸酶、谷氨酸草酰乙酸转氨酶、肌酸磷酸同功酶。结果:1.组织学显示为炎性细胞的渗出。2.大部分标本的粘度都很大,以致即使没有咽鼓管阻塞也难以被排出。3.渗出液内含酶量丰富。这些酶同样产生于排出管道阻塞所引起的其他疾病。4.渗出液纵然不是全部也是绝大部分由中耳粘膜渗出。通过上述结果,得出这样的病理生理设想:咽炎→咽鼓管咽口水肿→中耳内正常产生的分泌液排出受阻→分泌液积留→中耳内分泌液引起的化学性炎性反应→咽鼓管鼓室口水肿→临床上显示的渗出性中耳炎。
The author attempts to put forward the hypothesis of the pathophysiology of exudative otitis media by studying the biochemical and histological findings of 289 middle ear exudates. Measurement items are: trace viscosity determination, smear Wrights staining, total protein, glucose, acid phosphatase, alkaline phosphatase, glutamate oxaloacetate transaminase, creatine phosphate isoenzyme. Results: 1. Histology showed exudation of inflammatory cells. 2. Most specimens are so viscous that they are difficult to expel even without occlusion of the eustachian tube. Exudate contains abundant enzyme. These enzymes also arise from other diseases caused by obstruction of the drainage tubing. 4. Exudate, if not all, but also the vast majority of the middle ear mucosal exudation. Through the above results, come to such a pathophysiological assumption: pharyngitis → eustachian tube pharyngeal edema → secretion of the middle ear normally produced excretion of excretion → secretion retention → middle ear secretions caused by chemical inflammatory reaction → pharynx Drum tympanic cavity edema → clinically exudative otitis media.