小型猪颌下腺自体再植的实验研究  

Establishment of submandibular gland autotransplantation model in miniature swine and the histological changes of the transplanted gland

作　　者：葛兮源[1] 俞光岩[1] 蔡志刚[1] 毛驰[1] 

机构地区：[1]北京大学口腔医学院口腔颌面外科,100081

出　　处：《现代口腔医学杂志》2005年第2期172-176,共5页Journal of Modern Stomatology

基　　金：国家自然基金资助项目(编号:30340066);科技部基金资助(编号:2003ccc00800)

摘　　要：目的在小型猪体内建立颌下腺自体再植模型,并观察再植后颌下腺的组织学变化。方法小型猪8只(16侧颌下腺)分为三组第一组,4侧颌下腺移植到自体腹股沟区;第二组,6侧颌下腺原位再植到颌下区,导管外置于皮肤;第三组,6侧颌下腺原位再植到颌下区,导管开口于口腔前庭。术后以导管口分泌情况及移植腺体病理检查确定手术效果。结果第一组术后腺体全部发生血栓,腺体未能成活。第二组腺体成活有分泌3例,导管阻塞3例。第三组术后腺体成活有分泌5例,导管阻塞1例。病理检查结果显示成活腺体术后一周内,部分浆液细胞和粘液细胞可见明显的凋亡和变性。结论小型猪颌下腺不适合移植到腹股沟区。采用自体原位再植可成功建立小型猪颌下腺再植模型,其中导管开口于皮肤手术操作相对简单,适于短期观察。导管开口于口腔前庭的远期效果优于导管外置,适于长期观察。移植后腺细胞凋亡及变性可能是自体颌下腺移植术后发生休眠期时腺体分泌减少、变粘稠的病理学基础。Objective To establish a submandibular gland autotransplantation model in miniature swine and to observe the histological changes of the transplanted gland.Methods Sixteen submandibular glands were transplanted in 3 groups:①four submandibular glands were transplanted into the groin; the ends of secretory ducts were opened outside the skin.②Six submandibular glands were orthotopically transplanted into the submandibular triangle; the ends of secretory ducts were opened outside the skin.③Six submandibular glands were orthotopically transplanted into submandibular triangle; the secretory ducts were opened outside the oral vestibule through a subcutaneous tunnel. The results were assessed by visual inspection of the secretion and histopathologic examination of the transplanted submandibular glands.Results The first group failed due to venous thrombosis. In the second group, 3 cases failed due to obstruction of duct while the other 3 cases survived over 3 months. In the third group, 1 case failed due to obstruction of duct and the other 5 cases survived over 3 months. One case of ranula was found in the third group after the operation. Obvious apoptosis and degeneration were observed in secretory cells within 1 week after the operation.Conclusion The technique of transplanting submandibular glands into the submandibular triangle and suturing the orifice of the duct to the mucous membrane of the oral vestibule is successful as a submandibular gland autotransplantation model. The groin is not a feasible recipient site; more attention should be paid to avoid the occurrence of ranula or ductal obstruction when a submandibular gland is transplanted to the submandibular triangle. Apoptosis and degeneration may be the reason for decrease of submandibular gland secretion in a short term after the transplantation.

关 键 词：颌下腺 自体 腺体 原位再植 术后 小型猪 导管 分泌 变性 腺细胞 

分 类 号：R782.7[医药卫生—口腔医学]