磁牵引舌骨悬吊术在OSAHS动物模型中的有效性研究  

Efficacy of magnetic traction hyoid suspension surgery in the animal model of OSAHS

作　　者：许崇文[1,2] 杨邡俪 戴皓 赵谦 张少强[1] 闫金凤[1] 白艳霞[1] 白纪刚[2,3] XU Chongwen;YANG Fangli;DAI Hao;ZHAO Qian;ZHANG Shaoqiang;YAN Jinfeng;BAI Yanxia;BAI Jigang(Department of Otorhinolaryngology-Head and Neck Surgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases,College of Stomatology,Xi’an Jiaotong University,Xi’an 710004;Department of hepatobiliary surgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院耳鼻咽喉头颈外科,陕西西安710061 [2]西安交通大学口腔医院陕西省牙颌疾病临床医学研究中心,陕西西安710004 [3]西安交通大学第一附属医院肝胆外科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2023年第3期460-465,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发计划项目(No.2022SF-159);陕西省自然科学基础研究计划项目(No.2021JQ-386);“西安交通大学口腔医院陕西省牙颌疾病临床医学研究中心”开放课题(No.2017YHJB07)。

摘　　要：目的探索A型肉毒杆菌毒素注射方法制作大白兔舌后坠阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)动物模型的有效性,并探索磁控舌骨牵引手术方案的有效性及安全性。方法12只成年雄性实验用大白兔随机分为两组,实验组动物颏舌肌内注射肉毒杆菌毒素溶液0.4 mL(10 U),构建舌后坠OSAHS动物模型,对照组动物颏舌肌内注射生理盐水0.4 mL。设计并3D打印可装载钕铁硼内磁体及外磁体的聚丙烯酸酯外壳,建模成功后在实验组动物舌骨上固定内磁体装置,术后10 d实验组动物佩戴装载外磁体的聚丙烯酸酯颈托。应用动脉血氧检测仪测量建模前后及佩戴颈托前后实验组动物股动脉血氧饱和度(oxygen saturation,SaO_(2))及颏舌肌注射前后对照组动物股动脉SaO_(2),多层CT平扫测量两组动物上气道最窄处直径。结果实验组动物颏舌肌内注射A型肉毒杆菌毒素后5 d逐渐出现活动减少,呼吸费力及口唇、耳缘青紫等低氧血症表现,体质量由(3.72±0.21)kg下降至(3.40±0.20)kg,股动脉平均SaO_(2)由(93.84±5.14)%降至(84.00±3.35)%,上气道最窄处直径由(4.83±0.47)mm下降至(3.52±0.83)mm(P<0.05);对照组动物体质量、股动脉平均SaO_(2)及上气道最窄处直径颏舌肌内注射生理盐水前后无明显变化(P>0.05)。实验组动物完成磁牵引舌骨悬吊术,术后佩戴含外磁体的颈托行舌骨磁力牵拉后,实验组动物食量及活动量增加,口唇颜色由青紫转为粉红,股动脉SaO_(2)明显上升至(90.44±5.95)%,上气道最窄处直径较佩戴前增大至(4.42±0.15)mm(P<0.05)。结论大白兔颏舌肌注射A型肉毒杆菌毒素可有效构建舌后坠OSAHS动物模型。磁牵引舌骨悬吊术可有效纠正舌后坠导致的上气道狭窄及低氧血症症状。Objective To explore the effectiveness of creating the obstructive sleep apnea hypopnea syndrome(OSAHS)animal model of glossocoma using the botulinum toxin type A in white rabbits,and to explore the effectiveness and safety of magnetic traction hyoid suspension operation in the OSAHS animal model of glossocoma.Methods A total of 12 adult male experimental white rabbits were randomly divided into two groups.The animals in the experimental group were injected with 0.4 mL(10 U)of botulinum toxin type A in the genioglossus muscle to construct the OSAHS animal model of glossocoma.The animals in the control group were injected with 0.4 mL of normal saline.We designed and 3D printed a polyacrylate shell that could be loaded with inner and outer neodymium iron boron(NdFeB)magnets.After the modeling,a polyacrylate shell with the inner magnet device was fixed on the hyoid bone of the animals in the experimental group.All animals in the experimental group wore the polyacrylate orthotic neck brace containing the outer magnet 10 days after the operation.The arterial blood oxygen detector was used to record the oxygen saturation(SaO_(2))of the femoral artery,and multi-slice CT plain scan was used to measure the diameter of the narrowest part of the upper airway.Results The animals in the experimental group gradually showed decreased activity,labored breathing,blue lips and ear margins and other manifestations of hypoxemia 5 days after intramuscular injection of botulinum toxin type A in the genioglossus,and their body weight dropped from(3.72±0.21)kg to(3.40±0.20)kg,the average SaO_(2) of the femoral artery decreased from(93.84±5.14)% to(84.00±3.35)%,and the diameter of the narrowest part of the upper airway decreased from(4.83±0.47)mm to(3.52±0.83)mm(P<0.05).In the control group,the animals’weight,the average SaO_(2) of the femoral artery,and the diameter of the narrowest part of the upper airway did not significantly change before and after injection of normal saline into the genioglossus muscle(P>0.05).The animals i

关 键 词：磁牵引舌骨悬吊术 阻塞性睡眠呼吸暂停低通气综合征(OSAHS) 舌后坠 动物模型 

分 类 号：R735.2[医药卫生—肿瘤]