犬声带激光损伤模型的建立及意义  

The Establishment and Significance of A Canine Vocal Fold Injury Model by Semiconductor Laser

作　　者：韩鹏[1] 梁媛媛[1] 赵昱[1] 刘阳[1] 杨润琴[1] 邓志宏[1] 

机构地区：[1]第四军医大学西京医院耳鼻咽喉头颈外科中心,西安710032

出　　处：《听力学及言语疾病杂志》2012年第2期140-144,共5页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金资助(30973285)

摘　　要：目的建立支撑喉镜下犬声带激光损伤模型,观察其声带损伤愈合的大体形态学及组织学变化,为研究声带损伤后的修复提供动物模型。方法选用中华田园犬5只,4只于支撑喉镜下以半导体激光损伤双侧声带膜部中后1/3,深达甲杓肌,1只犬未行任何处理作为对照组。分别在术后4d、2、4及8w于支撑喉镜下观察声带大体形态改变后,各处死1只犬取声带损伤部位组织,通过HE染色、Masson三色染色、EVG染色、爱先蓝染色及免疫组化染色观察声带固有层胶原、弹力纤维、透明质酸(HA)及纤维连接蛋白(fibronectin)含量及分布的变化。结果术后4d支撑喉镜下见犬双侧声带充血水肿,组织切片示上皮未被覆固有层,损伤处大量炎性细胞侵润,固有层、肌层结构混乱不清;2w时喉镜下见声带充血水肿较前减轻,切片示受损部位上皮完全被覆,炎性细胞较前减少,胶原增生并排列紊乱,弹力纤维含量减少,HA含量下降,纤维连接蛋白含量增加;4w时喉镜下见声带炎症反应基本消失,受损部位表面不规则,瘢痕形成,切片示受损部位固有层被致密的纤维组织所替代,胶原含量持续增加,弹力纤维含量略下降,HA含量持续下降,Fibronectin含量持续增加;8w时喉镜下仍可见声带瘢痕,损伤处局部萎缩,切片示胶原呈粗大条索状,弹力纤维含量趋于稳定,HA含量下降,Fibronectin含量略上升。结论半导体激光可造成犬声带膜部热损伤模型,损伤后声带固有层内大量纤维组织形成,胶原含量上升,弹力纤维含量降低,HA含量降低,为研究声带损伤修复提供了可靠的动物模型。Objective To establish a canine vocal fold injury model by semiconductor laser under laryngo- scope, observe the gross morphology and histological changes of the injured vocal folds, and provide a reliable ani- mal model for vocal fold injury repair. Methods Five dogs, 8 vocal folds of 4 dogs were injured by semiconductor laser under laryngoscope. One dog without any treatment served as control. Gross morphological changes of the in- jured vocal folds were observed after surgery, one dog was sacrifices in 4 d, 2 w, 4 w and 8 w after surgery respec- tively. The changes of ECM composition of vocal folds were observed by HE staining, Masson trichrome, EVG stain and Alican blue staining. Results Fours days after surgery, acute inflammation was observed in bilateral vocal folds. Two weeks after surgery, acute inflammation was reduced and the lamina propria layer（LP） was covered with epithelium. The content of collagen was increased while the elastin was decreased. The content of hyaluronic acid （HA） was decreased while the fibronectin was increased. Fours weeks after surgery, the inflammation was disap- peared , and scars were observed on the injured parts of the vocal folds. Collagen content was increased continually while the elastin was decreased. The content of HA was decreased while the fibronectin was increased. Eight weeksafter surgery, the scars and atrophy were observed. Collagen showed a thick bundle--like shape while elastin densi- ty was stabilized. HA content was decreased slightly while Fihronectin was increased. Conclusion This study suc- cessfully established a canine model of vocal fold thermal injury caused by semiconductor laser. Fibrous tissue could be observed in the injured LP, and the collagen content was increased while the contents of elastin and HA was de- creased. This study provides a reliable animal model for vocal fold injury repair.

关 键 词：声带 动物模型 支撑喉镜 半导体激光损伤 

分 类 号：R767.8[医药卫生—耳鼻咽喉科]