咽后瓣术后组织形态变化的实验观察

目的　研究咽后瓣术后愈合动态的组织形态变化。方法　 10只成年健康杂种狗为实验对象 ,随机分为 2组 ,分别模拟上、下蒂型咽后瓣手术 ,于术后 0、3、7、30、90d处死 ,采用常规石蜡切片、光镜观察及计算机图像分析相结合的方法 ,比较术后不同时期瓣愈合的动态组织形态变化。结果　 (1)上、下蒂型咽后瓣术后当天瓣内组织无炎症及水肿 ,肌纤维排列规则 ;术后 3d时瓣组织水肿 ,大量炎症细胞浸润 ,肌纤维粗大 ;术后 7d水肿消退 ,少量炎症细胞浸润 ,肌纤维大小与当天时类似 ;术后 30d时瓣内结缔组织增多 ,未见炎症细胞 ,肌纤维变细 ,成为菱角形 ;术后 90d时瓣内组织变化与 30d时基本类似。 (2 )形态计量分析 (与当天比较 ) ,术后 3d时 ,肌纤维平均截面积及直径显著增加 (P <0 .0 1) ;术后 7d时无显著增加 (P <0 .0 5 ) ;术后 30d及 90d肌纤维平均截面积及直径显著减少(P <0 .0 1) ;两者比较 ,无显著差异 (P >0 .0 5 ) ;上、下蒂型咽后瓣术后同期互相比较差异无显著性 (P <0 .0 5 )。结论　上、下蒂型咽后瓣术后组织学变化类似 ,术后 30d肌纤维萎缩明显 ,90d呈稳定的萎缩状态。

THE HISTOMORPHOLOGICAL CHANGES OF POSTERIOR PHARYNGEAL FLAP: AN EXPERIMENT STUDY IN DOGS

Objective To study the histomorphological changes that occurred in the superiorly based posterior pharyngeal flaps(SPPF) and inferiorly based posterior pharyngeal flaps(IPPF) in different time postoperatively. Methods This experiment was conducted on 10 mongrel adult dogs that were randomly divided into two experimental groups and were performed SPPF or IPPF surgery respectively. Experimental dogs were sacrificed on 0d, 3d, 7d, 30d, 90d postoperative respectively. histotomy, microsection and image processing system(AmericanHPIS 1000) was used for experimental observations. Results (1) Histological changes: TheSPPF and IPPF exhibited edema and inflammation on the 3th day postoperative. Muscle fiber in the flaps became crassitude. Many inflamatary cells were seen. The 7 day flap presented the same changes as the 0 day flap, The major changes were atrophy of muscle fibers and desposits of connective tissue among myofibers on the 30 and 90th postoperative day. Inflammation and edema were not found. (2) Morphmetric analysis: myofibers cross section area (CSA) and myofibers diameter (MD) were significant increased on the 3th postoperative day ( P < 0.01 ), compared with 0 day flap. Whereas 7 day flap was not significant change ( P >0.05). In the 30 day and the 90 day flap, the CSA and MD were significant reduced ( P <0.01). Conclusion Both SPPF and IPPF presented the same histomorphological changes after operation. Atrophy of muscle fiber was found in the 30 day and 90 day flap postoperative.