本文選題：兔 + 軟骨��； 參考：《昆明醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：對(duì)兔耳軟骨折疊的四種手術(shù)方法比較,尋找一種更有效,更穩(wěn)定,固定效果持久且損傷最小的手術(shù)方法,為臨床上招風(fēng)耳手術(shù)提供理論依據(jù)。 方法：選用5-8個(gè)月齡,體重2-2.5kg,雌雄不限家兔10只,20只兔耳隨機(jī)分為四組,A組、B組、C組、D組,每組5只兔耳。A組為單純絲線埋線固定折疊的兔耳軟骨,B組為單純慢吸收縫線埋線(吸收時(shí)間為6個(gè)月)固定折疊的兔耳軟骨,C組為絲線埋線+軟骨前刻痕,D組為絲線埋線+軟骨后刻痕；四種手術(shù)方法建立模擬人招風(fēng)耳手術(shù)兔耳軟骨折疊模型(圖4)。分別在其術(shù)后第0、7、14、21、28、35天,通過①大體觀察(肉眼和照相觀察)兔耳軟骨折疊厚度的回彈情況,②游標(biāo)卡尺測(cè)量兔耳軟骨折疊的厚度(圖5),③分別對(duì)術(shù)后第35天時(shí)折疊的兔耳軟骨切取后進(jìn)行HE染色,顯微鏡下觀察組織病理學(xué)改變。結(jié)果采用重復(fù)測(cè)量方差分析進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：①大體觀察兔耳軟骨折疊厚度隨時(shí)間的增長而增大,在術(shù)后第35天時(shí)觀察最明顯。②游標(biāo)卡尺測(cè)量A組和B組兔耳軟骨折疊的厚度,厚度逐漸變大,A組和B組在第35天時(shí)兔耳軟骨回彈厚度比0天時(shí)增加了3mm和2.7mm。C組和D組兔耳軟骨折疊的厚度測(cè)量,厚度逐漸變大,C組和D組在術(shù)后第35天時(shí)兔耳軟骨回彈厚度比0天時(shí)增加了1.7mm和1.9mm,比A組和B組回彈力弱(詳見圖30、31)。A組、B組與C組、D組之間差異有統(tǒng)計(jì)學(xué)意義(p0.05)。采用4種不同的手術(shù)方法之后,不同時(shí)間點(diǎn)的兔耳折疊軟骨回彈的差異具有統(tǒng)計(jì)學(xué)意義。按照α=0.05檢驗(yàn)水準(zhǔn),檢驗(yàn)結(jié)果,P0.05。③顯微鏡下A組和B組軟骨無明顯變化,A組和B組均有細(xì)胞膜軟組織輕度水腫,小靜脈擴(kuò)張,炎癥細(xì)胞反應(yīng),縫線周圍異物肉芽腫；A組絲線存在,B組炎癥反應(yīng)較A組重。C組和D組軟骨折疊處有類似新生軟骨細(xì)胞增生,折疊處細(xì)胞體積明顯變小、變少,沒有明顯軟骨膜,細(xì)胞呈三角形,體積大,胞漿紅色,胞核染色質(zhì)深,有水腫存在,有少量散在淋巴細(xì)胞浸潤。④經(jīng)檢驗(yàn),四種方法總的有差別后,我們進(jìn)行兩兩比較(如表3),A組和C組,A組和D組,B組和C組,B組和D組之間差異有統(tǒng)計(jì)學(xué)意義(p0.05)；A組和B組,C組和D組之間差異無統(tǒng)計(jì)學(xué)意義(p0.05)。 結(jié)論：①成功建立了模擬人招風(fēng)耳手術(shù)兔耳軟骨折疊模型；②絲線埋線+軟骨前刻痕(C組),絲線埋線+軟骨后刻痕(D組)取得了穩(wěn)定的固定耳廓效果,比單純埋線效果好；③絲線埋線+軟骨前刻痕(C組)與絲線埋線+軟骨后刻痕(D組)手術(shù)方法需經(jīng)過更多數(shù)量的動(dòng)物實(shí)驗(yàn)和更長時(shí)間的觀察,期待最終為臨床上招風(fēng)耳手術(shù)起到指導(dǎo)性作用。
[Abstract]:Objective: to find a more effective, stable, durable and minimally injuried surgical method for rabbit ear cartilage folding, and to provide a theoretical basis for clinical auricular surgery. Methods: a total of 10 rabbits, aged 5-8 months, weighing 2-2.5kg, were randomly divided into four groups: group A, group B, group C, group C, group D; Each group of 5 rabbits ears. Group A is a simple silk thread embedding thread fixed folding rabbit ear cartilage. Group B is a simple slow absorption suture embedding thread (absorption time is 6 months) fixed folding rabbit ear cartilage. Group C is a filamentous embedding line cartilage anterior indentation group D For the silk thread embedding line after the chondrocyte mark; Four kinds of surgical methods were used to establish rabbit ear cartilage folding model (Fig. 4). The springback of the thickness of rabbit ear cartilage was observed by 1 gross observation (naked and photographic observation) on the 7th day, 141th day, 2835th day after operation, respectively. 2Vernier caliper was used to measure the thickness of rabbit ear cartilage folding (Fig. 5). The rabbit ear cartilage was removed at the 35th day after operation for HE staining and histopathological changes were observed under microscope. Results repeated measurement variance analysis was used for statistical analysis. Results the thickness of cartilage fold in rabbit ear increased with the increase of time, and the thickness of cartilage fold in group A and group B was measured at 35th day after operation, and the thickness of articular cartilage was measured by 0.2 Vernier caliper on the 35th day after operation. The thickness of rabbit ear cartilage in group A and group B increased gradually at day 35 compared with that in group D at day 0. The thickness of cartilage folding in 3mm and 2.7mm.C groups and group D was measured. On the 35th day after operation, the thickness of rabbit ear cartilage springback increased by 1.7mm and 1.9 mm, which was weaker than that of group A and group B (see fig. 30). There was a significant difference between group B and group C (p0.05). After four different surgical methods, there were significant differences in the springback of rabbit ear fold cartilage at different time points. According to the test level of 偽 -0.05, there was no obvious change of cartilage in group A and group B under P0.05.3 microscope. There were slight edema of soft tissue, small vein dilatation and inflammatory cell reaction in group A and B, respectively. The inflammatory reaction in group B was more than that in group A. there were similar proliferation of new chondrocytes in the folding of cartilage in group A and group D, and the volume of cells in the fold became smaller and smaller, and there was no obvious chondroderma, and the cells were triangular. Large size, red cytoplasm, deep chromatin, edema, and a few scattered lymphocytes. There was no significant difference between group A and group C between group A and group D, between group B and group C, and between group B and group D. There was no significant difference between group A and group B and group C and group D. There was no significant difference between group A and group C and group D (P 0.05). Conclusion the rabbit ear cartilage folding model was successfully established by 1% 1. Group C (group C) and group D (group D) obtained stable results of fixing the auricle, which was better than that of only embedding thread. (3) Group C (Group C) and Group D (Group D) need more animal experiments and observation for a longer period of time. It is expected that the operation will play a guiding role in the clinical application of auricular surgery.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R-332;R764.9

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