应用牵张成骨术整复腭裂骨质缺损的组织学研究  

Distraction osteogenesis for repair of cleft palate──Histological and fluorescent labeling study

作　　者：陈刚[1] 刘宝林[1] 王大章[2] 李唐新[2] 郑光勇[2] 胡静[2] 

机构地区：[1]西安第四军医大学口腔医学院颌面外科,710032 [2]成都四川大学华西口腔医学院颌面外科

出　　处：《实用口腔医学杂志》2002年第4期322-325,共4页Journal of Practical Stomatology

基　　金：四川省重点科学技术研究项目资助 (G990 6)

摘　　要：目的 :观察牵张成骨术整复腭裂过程中 ,新骨组织形成与改建活动的特点 ,探讨新骨生成的规律。方法 :家猫 14只为实验对象。其中 12只建立人工腭裂实验模型。实验组 (动物 10只 ) :以 0 .4mm× 2次 /d的速度与频率牵张整复腭裂缺损。于术后固定期 2、4、6、8及 12周 ,观察期结束前 6d ,各对 2只动物肌注四环素标记 ( 30mg/kg)。 6d后取标本 ,切片行荧光显微镜及组织学观察 ,并与实验对照组及空白对照组 (动物各2只 )结果对比。结果 :实验组标本牵张区新骨组织均为膜内成骨 ,由中央向外分为胶原纤维区、新骨形成区及改建成熟区 ;随时间发展 ,新生骨逐渐取代纤维组织并改建成熟。软组织也得到相应伸展。对照组裂隙无自行修复。结论 :应用牵张成骨术矫治腭裂骨质缺损 ,以原位产生新骨 ,增加骨量的方式推移骨运送盘封闭腭裂裂隙。在良好固定条件下 ,新骨形成与改建活跃 。Objective: To observe the mechanism and characteristics of new bone formation and remodeling process during distraction osteogenesis (DO) in the reconstruction of bone defect in cleft palate (CP). Methods: Sagittal palatal osteoectomy were performed in 12 cats to establish the CP model. The CP defects were reconstructed by intraoral distractors at the rate and rhythm of 0.4 mm×2/day till the transport disc (TD) reached the opposite edge across the defect region. Tetrachloride fluorescent labeling was administered 6 days before euthanasia specimen retrieval at 2, 4, 6, 8, 12 weeks through fixation period. Histological and fluoroscopical study were performed; control groups (2 animals in each group) were set for comparison. Results: The bone defect of CP was successfully reconstructed by DO. Exclusively intramembranous de novo osteogenesis were observed. Soft tissues attaching to TD were elongated simultaneously. No spontaneous repair was observed in control animals. Conclusion: With effective distraction and steady fixation, CP bone and soft tissue defect can be reconstructed by active intramembranous bone formation and remodeling following the applicaion of DO.

关 键 词：骨质缺损 组织学研究 牵张成骨 腭裂 动物模型 荧光标记技术 

分 类 号：R782.22[医药卫生—口腔医学]