扩张皮瓣下自体耳廓软骨移植的实验研究

目的:探讨扩张皮瓣对自体移植软骨生长及组织学形态的影响。方法:在10只4周龄新西兰大白兔右侧背部预制扩张皮瓣,取幼兔耳廓中部相对应的两个1 cm×1 cm的软骨(分别用于测量和观察)置于扩张皮瓣下(实验组),左侧背部未扩张区域(对照组)采用同样的方法移植软骨,每周采集1次观察软骨标本,共8周,作组织学观察,第8周末取出测量软骨进行面积测量。结果:实验组软骨增长了76.27%,对照组增长了52.95%(P<0.01)。镜下观察:实验组软骨前2周软骨活力下降、基质分泌减少,第3~8周软骨活力增强,第6周达到高峰,以后软骨活力逐步下降,但仍高于移植前软骨。对照组软骨第1周软骨活性略有下降,第2周软骨形态基本和移植前软骨一致,第3~8周软骨活力增强,在第5周为高峰期。结论:幼兔耳廓软骨自体移植于扩张皮瓣后成活良好,生长呈曲线过程,实验组软骨增长较对照组快。

Experimental study of the young rabbit's ear cartilage autograft in expanded flap

Objective：To explore the effect of the expanded flap on the grafts of autogenous ear cartilage. Methods：Ten New Zealand white rabbits were involved and the right back skin flaps（ experimental group）were expanded with 15 ml tissue expanders while the left sides （control group） weren＇t, after four weeks expansion we put two 1 cm × 1 cm cartilages from the middle place of the same side ear （one was for measure ,the other was for observation）into the expanded skin flaps and the same to the counterpart of the right side. The cartilages were observed for histologic and morphologic examination weekly, and measured 8 weeks later. Results：The eartilage showed 76.27% increase in surface area in the experimental group, while 52.95% increase in the control group （P 〈 0.01 ）. Microscopic observation：in experimental group the activity of cartilage was impaired in the first two weeks. From 3rd to 6th week the activity of cartilage was gradually enhanced and reached to its peak at the sixth week, subsequently the cartilage＇s activity weakened gradually but still higher than pre-transplantation. In control group degeneration was observed in the first week, and the morphology was close to pre-transplantation a week later. From the 2nd to 5th week the cartilage growth trend was similar to the experimental group but the peak was the 5th week. Conclusions ：The autogenous cartilage of young rabbits had grown well in expanded flap. The growth trend of cartilage was a eurve：first descend then ascend and last descend.