高放射剂量照射后牵张下颌骨成骨的动物实验研究  

Distraction osteogenesis in the dog mandible following high dose irradiation

作　　者：柳玉晓[1] 刘桂才 刘彦普 朱国雄[1] LIU Yu-xiao,LIU Gui- cai,LIU Yan-pu,et al.(Department of Stomatology,the General Hospital of Jinan Military Region,Jinan,Shandong 250031, China)

机构地区：[1]原济南军区总医院口腔科,山东济南250031 [2]空军军医大学口腔医学院颌面外科,陕西西安710032

出　　处：《实用医药杂志》2018年第7期633-635,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨高放射剂量照射后犬下颌骨牵张成骨(DO)的可行性。方法 10只中国杂种犬随机分为两组,实验组8只,单侧下颌骨接受总剂量27.2 Gy,6.8 Gy,4次,2 W的60Co照射,对照组2只不接受照射。照射完成后6个月,各组分别于下颌骨照射区常规置入牵张器。经7 d延迟期,常规牵张下颌骨10 d,然后固定8 W。处死动物,观察牵张区成骨情况,对牵张区下颌骨和下牙槽神经进行放射学组织学检查。结果实验组牵张区未能发现新骨形成,但发生了严重的骨退行性变和放射性骨坏死。对照组新骨形成明显。实验组下牙槽神经退行性变严重,新生不良。对照组下牙槽神经修复性变化明显。结论高放射剂量照射对下颌骨和下牙槽神经损害严重,牵张成骨需谨慎。Objective To explore the probability of distraction osteogenesis（DO） in the dog mandible after high dose irradiation. Methods Ten dogs were randomly divided into two groups：Group experimental（8 dogs）received a unilateral irradiation from60 Co in the mandible with a total dose of 27.2 Gy in four 6.8 Gy fractions for2 weeks. The other 2 dogs without irradiation were taken as Group control. Bilateral corticotomy was made 6 months after completion of irradiation,followed by traditional procedure of DO. Gross,radiologic and histological evaluations were performed in the distracted area. The inferior alveolar nerve（IAN） was also evaluated by histological analysis. Results After 8 weeks of consolidation,no new bone formation were found but severe bone degeneration and osteoradionecrosis in the distraction gap in Group experimental were found. New bone formation was found in Group control. The histological analysis of IAN showed corresponding change during the process.Conclusion DO could be infeasible in previously irradiated dog mandible after high dose irradiation,should be taken carfully.

关 键 词：牵张成骨 高剂量放射照射 下牙槽神经 下颌骨 

分 类 号：R782.05[医药卫生—口腔医学] R815.6[医药卫生—临床医学]