肋软骨膜对肋软骨再生与塑形影响的实验研究

目的为提高漏斗胸手术治疗效果提供实验依据.方法将12只日本大耳白兔双侧第2、3肋软骨于肋软骨膜下完整地切除,右侧第2、3肋软骨膜行物理性破坏,将双侧第3肋软骨膜缝合成套管状结构,双侧第2肋软骨膜不缝合.术后2、4、6个月分别对再生肋软骨平均宽度及组织切片进行镜下观察和动态测量.结果①术后2、4、6个月,双侧再生第2肋软骨的平均宽度显著大于术前肋软骨的平均宽度(P＜0.05);②术后4、6个月,双侧再生第3肋软骨平均宽度与其术前肋软骨平均宽度相比无显著性差异(P＞0.05);③组织切片镜下观察,左侧未行肋软骨膜物理性破坏者,再生第2、3肋软骨软骨细胞的数量、分布及软骨基质的排列均优于右侧;④左侧再生第3肋软骨肋软骨膜未被破坏且被修复成套管状结构者,其再生的肋软骨的形态更接近于正常的肋软骨.结论肋软骨膜增殖层的完整性有利于肋软骨再生,将肋软骨膜缝合成套管状结构后有利于再生肋软骨的塑形,肋软骨膜是漏斗胸术后胸廓修复与重建的基础.

EFFECT OF COSTAL PERICHONDRIUM ON REGENERATION AND REMODELING OF COSTAL NEOCARTILAGE

OBJECTIVE: To provide experimental basis for improving the curative effect of pectus excavatum. METHODS: Twelve rabbits were adopted in this experiment. After the bilateral second and third costal cartilages of the rabbits were resected subperichondrially, their right second and third costal perichondriums were damaged intentionally. Then, the bilateral third costal perichondriums were stitched into a tube-like structure and the second ones were left opened. After 2, 4, 6 of operation, the bilateral second and third neocartilages were measured for their width, and histological character were observed under microscope. RESULTS: 1. After 2, 4, 6 months of operation, the average width of the bilateral second neocartilages were significantly greater than the preoperative ones. 2. 4 and 6 months after operations, there was no significant difference in the average width of the bilateral third neocartilages and the preoperative ones. 3. The amount, distribution of costal neocartilage cells and the arrangement of costal neocartilage matrix within the left second and third costal cartilages were better than the right under the light microscope. 4. The left third costal neocartilage was regenerated and remodeled better than all the others. CONCLUSION: The integrality of costal perichondrium is in favor of the regeneration of costal cartilage, and the sleeve stitch of costal perichondrium facilitates the remodeling of costal neocartilage.