犬头面部复合组织同种异体移植模型的建立  

Establishment of composite facial and scalp allograft transplantation model in canine

作　　者：郑胜武[1] 李青峰[1] 姜浩[1] 顾斌[1] 王会勇[1] 郑丹宁[1] 刘琴秀[1] 昝涛[1] 汤璐佳[1] 李玉萍[1] 谢芸[1] 陈瑜[1] 张涤生[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,200011

出　　处：《中华整形外科杂志》2006年第4期298-302,共5页Chinese Journal of Plastic Surgery

基　　金：教育部基金(NCET-04-0436);上海卫生科技发展基金(OZ-BR013)

摘　　要：目的建立犬头面部复合组织同种异体移植的实验动物模型。方法①解剖研究:用4只杂种犬进行头面颈部的解剖及复合组织瓣的切取研究。②自体回植(Ⅰ组n=5):为选择最佳的复合组织瓣移植方式,进行了三种形式的复合组织瓣自体回植。③异体移植(Ⅱ组n=6):以第三种复合组织瓣及其改良的组织瓣形式进行了两种头面部复合组织异体移植。免疫抑制治疗方案为环孢霉素A和皮质激素联合应用,依据环孢霉素A血药浓度调整用药剂量。分别在术后4、6、12周及6个月对眼轮匝肌进行肌电图检测。结果①犬头面部的解剖特征与人相似,以颈外动静脉为血管蒂能够为头面部复合组织瓣提供良好的血供。②Ⅰc组两只犬长期存活,但出现唾液漏。③Ⅱa组中1只犬于移植术后28 d免疫排斥,通过调整环孢霉素A及强的松的用量并局部应用氯倍他索涂抹,2周后治愈,现已存活309 d。Ⅱb组中3只犬现已分别存活159、129和108 d,无并发症,肌电图显示眼轮匝肌功能逐步恢复。结论改良犬单侧上半头面部组织瓣异体移植模型是研究头面部复合组织异体移植的理想模型。Objective To develop an experimental model of composite facial and scalp allograft in canine in order to investigate technical and immunological aspects and functional recovery of facial muscles of this new approach to facial reconstruction. Methods （1）Anatomic study： Four mongrel dogs were used for anatomical dissection of the head and neck region and for harvesting flap experiment. （2）Autolagous transplantation （group Ⅰ ） ： Three types composite facial and scalp autologous transplantation were performed in five mongrel dogs. Type Ⅰ composite tissue flap （group Ⅰ a n = 2） included bilateral external ear and orbicularis oculi muscle. Type Ⅱ（group Ⅰ b n = 1 ） included single-lateral external ear, orbicularis oculi muscle , external nose ,upper and lower lip. Type Ⅲ （group Ⅰ c n = 2）included singlelateral external ear and orbicularis oculi muscle. （3） Allograft transplantation（group Ⅱ ） ： In group Ⅱ a （ n = 2 ）, two allograft transplantation were performed with type Ⅲ composite facial and scalp . In group Ⅱ b（ n = 4）, four allograft transplantation were performed with the modified type Ⅲ composite facial and scalp which included single - lateral external ear ,orbicularis oculi muscle and one third of inferior tarsal plate and palpebral conjunctiva. To prevent allograft rejection, Cyclosporin A （CsA） and Methylprednisolone （MP） or Prednisone （PS） were combined used as immunosuppressive protocol . Dose of CsA was adjusted depending on its blood drug level. Electromyologram （EMG）of orbicularis oculi muscle was carried out at 4 weeks, 6 weeks, 12 weeks and 6 months postoperation. Results ①The facial anatomic characteristic of dog is similar to that of humanbeing, external carotid artery and external jugular vein afford good blood supply to composite facial and scalp. ②The dogs in group Ⅰ c were long-term surviving with leakage of salivary juice. ③In group H a （ n = 2）, one dog presented rejection reaction at 28th day pos

关 键 词：复合组织异体移植 面部移植 动物模型 

分 类 号：R-332[医药卫生]