不同时期宫内手术修复腭裂山羊的面中部发育变化研究  

EFFECT OF IN-UTERO SURGICAL REPAIR AT DIFFERENT STAGES ON MID-FACIAL DEVELOPMENT OF GOATS WITH CLEFT PALATE

作　　者：彭喆[1] 刘岩[1] 杨锴[1] 冯国平[1] 

机构地区：[1]北京大学人民医院医疗美容科,北京100044

出　　处：《中国修复重建外科杂志》2011年第9期1099-1102,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(30772266)~~

摘　　要：目的通过观察先天性腭裂山羊模型,研究不同时期宫内修复对山羊面中部发育的影响。方法取24只8～12月龄雌性杂交波尔山羊,体重35～55kg,以配种日期定为孕0d,于孕30d经B超确认怀孕后随机将实验动物分为5组。取其中20只分别于孕31～42d肌肉注射左旋毒藜碱(15mg/d)制备先天性腭裂动物模型;其余4只作为正常对照组不作处理,待其正常生产。20只实验动物模型形成后随机分为实验1、2、3、4组(n=5),前3组分别于孕65、90、120d采用改良兰氏法对宫内1只胎羊行腭裂修复术;实验4组作为未修复对照组。小羊出生后1个月,采用CT颅面测量技术,测量上颌最前磨牙前方的两侧凹陷处间距(posterior premolar morphological measurement,PPMM),及以此线为基准测量上颌骨最前点至此线的垂直距离(anterior premolar morphological measurement,APMM),最后制作干颅行大体观察。结果小羊出生后1个月,实验1组PPMM、APMM与正常对照组比较差异均无统计学意义(P>0.05),与实验4组比较差异均有统计学意义(P<0.05);实验2组PPMM、APMM与正常对照组、实验4组比较差异均有统计学意义(P<0.05);实验3组PPMM与正常对照组和实验4组比较差异均有统计学意义(P<0.05),APMM与正常对照组比较差异有统计学意义(P<0.05),但与实验4组比较差异无统计学意义(P>0.05)。实验4组的5只腭裂小羊仅存活1～2个月。结论对孕65d胎羊行宫内修复腭裂后对面中部发育影响最小,越接近孕晚期修复对面中部发育影响越大,但修复手术越早流产风险越高。Objective To study the mid-facial development characteristics of the goats with cleft palate after in-utero surgical repair at different stages.Methods Twenty-four Boer hybrid female goats were selected,aged from 8 to 12 months and weighing from 35 to 55 kg.The mating day was designated for 0 day.At 30 days,pregnant was confirmed by B-ultrasound test,and the goats were divided into 5 groups（experimental groups 1,2,3,4,and normal control group）.Twenty pregnant goats of 4 experimental groups（n=5） were injected DL-anabasine（15 mg/day） from 31 to 42 days to establish cleft palate model of fetal lamb,4 pregnant goats of normal control group used as controls without injection.At pregnant 65,90,and 120 days,cleft palate was repaired in the uterus in experimental groups 1,2,and 3,while cleft palate was not repaired in experimental group 4.After 1 month of birth,the maxillary bone width（posterior premolar morphological measurement,PPMM） and the maxillary bone length（anterior premolar morphological measurement,APMM） were measured with CT scanning.The dry skull of goats were harvested for gross observation.Results There was no significant difference in PPMM and APMM between experimental group 1 and the normal control group（P 〉 0.05）,but there were significant differences between experimental groups 1 and 4（P 〈 0.05） at 1 month after birth.Significant differences were oberved in PPMM and APMM between experimental group 2 and normal control group,experimental group 4（P 〈 0.05）.There were significant differences in PPMM between experimental group 3 and normal control group,experimental group 4（P 〈 0.05）,in APMM between experimental group 3 and normal control group（P 〈 0.05）.Five goats with cleft palate in experimental group 4 died at 1-2 months after birth.Conclusion At pregnant 65 days,in-utero surgical repair of cleft palate has less influences on mid-facial development.The earlier repair is performed,the higher risk of miscarriage was

关 键 词：宫内手术 左旋毒蔾碱 腭裂动物模型 面中部发育 胎羊 

分 类 号：R782.2[医药卫生—口腔医学]