本文選題：淚小管斷裂 + 動(dòng)物模型�。� 參考：《華中科技大學(xué)》2012年碩士論文

【摘要】：目的通過(guò)建立兔淚小管斷裂吻合聯(lián)合置管的動(dòng)物模型，觀察術(shù)后不同時(shí)間點(diǎn)兔淚小管斷裂后吻合口的病理變化及細(xì)胞增生情況，，探討淚道置管的最佳拔管時(shí)間。 方法距淚點(diǎn)3mm切斷淚小管制作兔淚小管斷裂損傷動(dòng)物模型。采用完全隨機(jī)方法將16只兔(32眼)分成A、B、C三組。A組為正常對(duì)照組2只兔（4眼）；B組單純吻合對(duì)照組2只兔(4眼)，吻合淚小管但不置管；C組為實(shí)驗(yàn)組12只兔(24眼)：吻合淚小管聯(lián)合置管組，再根據(jù)術(shù)后不同時(shí)間點(diǎn)（1月、2月、3月）拔管再分為3個(gè)亞組，每亞組4只兔8眼。術(shù)后4月，A、B組和C組各亞組2只兔(4眼)均行淚道沖洗檢查，淚道內(nèi)窺鏡檢查了解淚道粘膜情況，組織學(xué)病理學(xué)檢查觀察吻合口區(qū)病理變化及細(xì)胞增生情況。C組各亞組拔管時(shí)間點(diǎn)2只兔(4眼)亦進(jìn)行淚道沖洗、淚道內(nèi)窺鏡檢查和組織學(xué)病理學(xué)檢查，并與術(shù)后4月結(jié)果對(duì)比。 結(jié)果A組正常對(duì)照組（4眼）淚道沖洗均通暢；淚道內(nèi)窺鏡檢查正常；病理學(xué)檢查正常。B組（4眼）單純吻合對(duì)照組淚道沖洗均不通；淚道內(nèi)窺鏡檢查淚小管管壁粗糙、增厚，呈灰白色，大量無(wú)彈性的灰白色膜樣物質(zhì)；病理學(xué)檢查淚小管粘膜上皮細(xì)胞增生，排列成多層，少量炎癥細(xì)胞，上皮下結(jié)構(gòu)基本正常。C組吻合聯(lián)合置管實(shí)驗(yàn)組，術(shù)后1月拔管亞組（4眼）拔管時(shí)淚道沖洗3眼通暢，1眼不通；淚道內(nèi)窺鏡檢查粘膜呈淡粉紅色，管壁略粗糙，有少許膜樣物質(zhì)飄浮在淚小管內(nèi)；病理學(xué)檢查粘膜上皮細(xì)胞基本正常，管腔正常，部分上皮層脫落，上皮下結(jié)締組織增生。術(shù)后2月拔管亞組（4眼）拔管時(shí)淚道沖洗1眼通暢，3眼不通；淚道內(nèi)窺鏡檢查淚小管粘膜呈粉紅色，可見(jiàn)出血點(diǎn)，管腔狹窄，管壁見(jiàn)蒼白色瘢痕，淚小管內(nèi)可見(jiàn)大量膜樣物質(zhì)飄浮；病理學(xué)檢查粘膜上皮細(xì)胞增生，管腔有部分狹窄，上皮下可見(jiàn)結(jié)締組織增生。術(shù)后3月拔管亞組（4眼）拔管時(shí)淚道沖洗3眼通暢，2眼狹窄，1眼不通；淚道內(nèi)窺鏡檢查粘膜呈粉紅色，管腔肥厚，狹窄，有大量粉紅色模樣物質(zhì)；病理學(xué)檢查淚小管上皮細(xì)胞增生，管腔正常，上皮下結(jié)構(gòu)尚正常。C組各亞組術(shù)后4月時(shí)淚道沖洗檢查，淚道內(nèi)窺鏡檢查和組織學(xué)病理學(xué)檢查與拔管時(shí)相比基本相同。 結(jié)論兔淚小管斷裂損傷選擇吻合聯(lián)合置管術(shù)，術(shù)后1月拔管為宜，置管2月、3月瘢痕增生較1月明顯。
[Abstract]:Objective to establish an animal model of lacrimal canaliculus anastomosis and to observe the pathological changes and cell proliferation of lacrimal canaliculus after lacrimal canaliculus rupture at different time points, and to explore the optimal extubation time of lacrimal canaliculus.Methods the lacrimal canaliculus was cut off by 3mm from lacrimal point to make rabbit lacrimal canaliculus injury model.16 rabbits (32 eyes) were randomly divided into three groups: group A: normal control group (n = 2); group B: simple anastomosis of control group (n = 2); group C: group C (n = 12): anastomosis of lacrimal canaliculi but without tubules; group C (n = 12);Lacrimal canaliculus combined catheterization group,According to the different time points (1, 2, 3 months), the extubation was subdivided into 3 subgroups, 4 rabbits in each subgroup (8 eyes).Four months after operation, lacrimal passage irrigation was performed in 2 rabbits in group B and group C) and lacrimal duct mucosa was examined by endoscopy.Histopathological examination: histopathological changes and cell proliferation in anastomotic area. Group C (4 eyes) were treated with lacrimal passage irrigation, endoscopy and histopathology, and the results were compared with those of 4 months after operation.Results in group A, lacrimal passage irrigation was smooth in 4 eyes of normal control group; endoscopy of lacrimal duct was normal; pathological examination was normal in 4 eyes of group B) the lacrimal duct wall was coarse and thickened by endoscopy of lacrimal duct, and lacrimal duct wall was coarse and thickened by endoscopy of lacrimal duct.The epithelium of the lacrimal tubule was proliferated and arranged into multiple layers, a small number of inflammatory cells, and the subepithelial structure was basically normal.1 month after the extubation, 4 eyes in the extubation group) 3 eyes had lacrimal passage irrigation and 1 eye was impassable during extubation, the mucosa of lacrimal duct was light pink, the wall of the tube was slightly rough, and a little membrane-like substance was floating in the lacrimal duct.Pathological examination showed that the mucosal epithelial cells were normal, the lumen was normal, part of the epithelium was exfoliated, and the epithelium was proliferating.2 months after extubation, 4 eyes in the extubation group (4 eyes) had lacrimal passage irrigation in 1 eye and 3 eyes in the extubation group. Endoscopy of lacrimal duct showed that the mucous membrane of lacrimal canaliculus was pink, bleeding point was visible, lumen was narrow, and pale white scar was seen on the wall of the tube.A large number of membrane-like substances could be seen floating in the lacrimal tubule. Pathological examination showed that the mucosal epithelial cells proliferated, the lumen was partly narrow, and the connective tissue proliferation was seen in the upper subcutaneous layer.3 months after the extubation, 3 eyes of the extubation group (4 eyes), 3 eyes of the lacrimal passage irrigated unobstructed and 2 eyes with stenosis and 1 eye obstruction, the mucous membrane of the lacrimal duct was pink, the lumen was hypertrophic and narrow, and there were a lot of pink appearance material.The epithelial cells of lacrimal tubules proliferated and the lumen of lacrimal tubules were normal. The lacrimal passage irrigation examination, endoscopy examination and histopathological examination of lacrimal duct were similar to those of extubation 4 months after operation in group C.Conclusion the canaliculus fracture injury in rabbits was combined with anastomosis and extubation at one month after operation. The scar hyperplasia in 2 months and 3 months was more obvious than that in 1 month.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R779.6

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