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目的观察乙状结肠代阴道成形术后黏膜的形态学改变及黏膜内神经型一氧化氮合酶(nNOS)表达的变化。方法对14例代阴道的乙状结肠黏膜及14例正常乙状结肠黏膜标本应用光镜、电镜进行形态学检查,采用免疫组化方法对黏膜的 nNOS 表达进行半定量研究。结果乙状结肠代阴道成形术后人工阴道上段黏膜肌层增生肥厚,黏膜下层神经丛密度增加(3.6±1.5 vs 1.7±0.8,P<0.05);部分下段黏膜有鳞状上皮化生。电镜见代阴道结肠黏膜杯状细胞的分泌泡较少,上皮细胞间紧密连接有部分融合,粗面内质网有脱颗粒现象。代阴道乙状结肠黏膜上皮、黏膜腺体内nNOS 的表达较正常乙状结肠黏膜减弱。结论乙状结肠代阴道成形术后黏膜发生了形态学改变,以下段变化明显。
Objective To observe the morphological changes of mucosa and the expression of nerve nitric oxide synthase (nNOS) in the sigmoid colon after vaginal plasty. Methods 14 cases of vaginal sigmoid colon mucosa and 14 cases of normal sigmoid colon mucosa were examined by light microscopy and electron microscopy. The expression of nNOS in mucosa was semi-quantitatively studied by immunohistochemistry. Results The sigmoid colon hyperplasia and hypertrophy of the superior vaginal mucosa in the sigmoid colostomy resulted in an increase in the density of the submucosal nerve plexus (3.6 ± 1.5 vs 1.7 ± 0.8, P <0.05). Some of the lower mucosa had squamous metaplasia. Electron microscopy on behalf of the vaginal colonic mucosa goblet cells secreted less, epithelial cells tightly connected with some fusion, rough endoplasmic reticulum degranulation. A generation of vaginal sigmoid colon mucosa, mucosal gland nNOS expression than the normal sigmoid colon mucosa weakened. Conclusion The sigmoid colon vaginoplasty mucosa morphological changes, the following paragraph changes significantly.