咽后瓣术后组织超微结构变化实验研究

The ultrastructal changes of posterior pharyngeal flap: An experiment study in dogs

目的 :观察咽后瓣术后组织超微结构变化 ,探讨咽后瓣术后组织瓣萎缩的原因。方法 :以 10只成年健康杂种狗为实验对象 ,随机分为两组 ,分别模拟上、下蒂型咽后瓣手术 ,于术后 3 0 ,90d处死 ,以术后当天为各自正常对照组 ,采用超薄切片透射电镜观察。结果 :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 ,肌丝排列紧密、规则 ,Z线及肌节清晰 ,肌膜完整 ,肌原纤维整齐 ,横纹清晰 ;术后 3 0d时肌原纤维出现断裂、溶解 ,排列紊乱 ,Z线弯曲或断裂 ,肌原纤维之间有大量的空泡出现 ;术后 90d时上蒂型咽后瓣内可见肌纤维再生 ,下蒂型咽后瓣组织变化与 3 0d时基本类似。结论 :上蒂型咽后瓣显示较好的远期效果。

Objective:This experiment attempts to study the Ultrastructal changes that occurred in the superiorly and inferiorly based posterior pharyngeal flaps in different time postoperatively.Method: This experiment was conducted on 10 mongrel adult dogs that were randomly divided into two experimental groups, which was performed superiorly or inferiorly based posterior pharyngeal flap surgery respectively. Experimental dogs were sacrificed on 30d, 90d postoperative respectively. microsection was used for experimental observation.Result:Ultrastructal examination of transmission electron microscope revealed alteration in Z-line and myofibril. Z-line present abrupt. Myofibrils were disorganized. In 90-day flap, histological changes were the same!as the 30-day flap. But in 90-day superiorly based posterior pharyngeal flap, the immature myofibril was seen. Myofibril and Z-line presented organized. The membrane of the myofibril was undistinguished.Conclusion: Using an animal model of posterior pharyngeal flap surgery, The immature myofiber has been found in the superiorly based posterior pharyngeal flap on the 90th postoperative day. The future of the flap may be good. But in 90-day inferiorly based posterior pharyngeal flap, the immature myofiber was not seen.