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目的建立犬同种异体颜面复合组织移植的动物模型,观察移植后面神经的再生情况。方法 (1)模型建立:取杂种犬3只进行头颈部(主要是血管系统和面神经颅外段)的解剖研究。明确血管蒂所能营养组织块的最大范围,寻求最合适的血管蒂进行复合组织瓣移植。(2)移植后面神经再生的观察:以2只Beagle犬分别作为供/受体,建立实验动物模型后,环孢素A与皮质激素联合应用作为免疫抑制治疗方案。术后60,100 d分别行面神经肌电图检测,术后100 d取移植面神经吻合口标本行病理观察,分析移植后面神经的再生情况。结果 (1)犬头颈部血管和面神经颅外段的分支及走向与人类似,面神经颊支粗大且走向恒定,可作为移植神经。进行犬半侧颜面组织瓣移植最合适的血管蒂应是颈外静脉和颈外动脉。(2)移植术后60 d神经肌电图检测指标潜伏期较正常明显延长,波幅明显减小,100 d时潜伏期与波幅均较前明显恢复改善。神经吻合口的组织学结构接近正常。结论建立包含面神经的犬同种异体颜面复合组织移植动物模型具有可行性,可作为长期观察的动物模型。移植后面神经的再生是个较为缓慢的过程,移植100 d神经吻合口远端可出现组织结构上较为成熟的再生神经纤维,但要达到功能上的恢复尚需更长的时间。
Objective To establish an animal model of canine allograft facial tissue transplantation and observe the regeneration of facial nerve after transplantation. Methods (1) The model was established: Anatomical study of the head and neck (mainly the vascular system and facial nerve extracranial segments) was performed in 3 mongrel dogs. Clear the maximum range of vascular pedicle can nutrition tissue block, to find the most suitable vascular pedicle compound tissue flap transplantation. (2) Observation of facial nerve regeneration after transplantation: Two immunosuppressive treatment regimens were used in combination with corticosteroids after establishment of experimental animal model with two Beagle dogs as donor / recipient respectively. The facial nerve electromyography was performed on the 60th and 100th day after operation. The pathological changes of the transplanted facial nerve anastomosis were observed 100 days after the operation to analyze the regeneration of facial nerve after transplantation. Results (1) The branch and the direction of the extracranial segments of the blood vessels and facial nerve of the canine head and neck Similar to human, the buccal branch of the facial nerve is thick and constant and can be used as a grafted nerve. The most suitable vascular pedicle for canine half facial flap transplantation should be the external jugular vein and the external carotid artery. (2) After 60 days of transplantation, the indexes of neuroelectrophonegraphic examination showed that the latent period was significantly longer than normal, and the amplitude was significantly reduced. The latency and amplitude at 100 days were obviously recovered and improved. Histological structure of anastomotic nerve close to normal. Conclusion It is feasible to establish animal model of canine facial allograft with facial nerve and can be used as an animal model for long-term observation. Regeneration of the transplanted facial nerve is a relatively slow process. More mature regenerated nerve fibers may appear on the distal end of the 100-day nerve anastomotic graft, but it takes longer to achieve functional recovery.