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兔声带注射脱细胞真皮基质和自体脂肪的实验研究

Experimental Study on Acellular Dermal Matrix and Autologous Fat Injected into Rabbit Vocal Cords

郝媛媛;孙建军;

1:安徽医科大学海军临床学院

2:海军总医院耳鼻咽喉头颈外科

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摘要

目的探讨自体脂肪和脱细胞真皮基质(acellular dermal matrix,ADM)声带填充的临床应用价值。方法 16只新西兰兔建立单侧声带麻痹模型后,随机分为脂肪组(麻痹侧声带注射自体脂肪)和ADM组(麻痹侧声带注射ADM),每组8只。每组动物于声带注射术后2、4、8和12周各取2只行纤维喉镜检查观察声带形态变化后,处死动物并取出全喉,沿喉轴位自室带至声门下连续切片,进行HE染色,高倍光学显微镜下观察填充材料组织学改变,并使用autoCAD软件进行填充材料剩余体积估算。结果两组的声带填充材料剩余体积均随时间逐渐缩小,缩小的速度差异无统计学意义(P>0.05)。脂肪组自体脂肪注射术后2周可见成活的脂肪细胞呈团块状分布,与周围组织未形成较明显分界,后成活的脂肪细胞逐渐减少,代之以纤维结缔组织相连的多个大泡,四周存活少量的脂肪细胞;术后3月脂肪团块周围被纤维结缔组织包绕,形成明显的包膜。ADM组术后2周微粒间可见成纤维细胞长入及新生血管形成,随后成纤维细胞逐渐增多,术后3月植入的ADM团块仍可见基本轮廓,组织结构较致密,但与周围组织界限不明显。结论兔声带注射自体脂肪和ADM后的吸收速率无显著差异,但ADM植入后组织相容性好,可逐渐被原有组织改建、替代,作为声带注射填充材料有较大的发展空间和临床应用价值。

关键词

声带麻痹;声带注射;自体脂肪;脱细胞真皮基质

基金项目(Foundation):

作者

郝媛媛;孙建军;

参考文献

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声带麻痹声带注射自体脂肪脱细胞真皮基质

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郝媛媛孙建军