颞下颌关节骨关节病临床病理研究

Clinical Pathology Study of Temporomandibular Osteoarthrosis.

目的:研究颞下颌关节骨关节病的病理特点。方法:选取30例颞下颌关节骨关节病患者,均进行手术治疗。所有获取的新鲜标本用4%的福尔马林固定,然后用5%的甲酸脱钙,梯度酒精脱水,石蜡包埋,5μm厚连续切片,HE染色,光镜观察。结果:关节软骨表层纤维毛糙,排列紊乱,纤维水肿,互相分离,有的纤维断裂,出现水平裂隙及垂直裂隙;增殖带变薄甚至消失,有的软骨层明显增厚,增殖带内未分化间充质细胞较多;肥大带内可见到较多软骨细胞,细胞内有空泡形成;钙化层与非钙化层之间出现明显的潮标线;密质骨变薄,软骨直接与松质骨骨髓腔相通。结论:骨关节病的主要病理特征表现为关节软骨的破坏和增生,有时伴随软骨下骨质的破坏与改建。

Objective ： To study the pathological characters of temporomandibular osteoarthrosis. Methods ： The study consisted of 30 patients （6 males and 24 females）. All specimens were gained by surgery. The gross specimens were fixed in a solution of 4% neural formaldehede, decalcified by 5% formic acid and dehydrated in a graded series of alcohol. Results： Under micrograph,pathological changes were found in all OA specimens. Focal swelling, thinning of the cartilage and even vertical and horitical splitting in the cartilage were observed; The collagen network showed signs of disorganization. Chondrocyte degeneration and necrosis could also be found. Sometimes the cartilage was completely destroyed and replaced by fibrous tissue,extending through subchondral bone into marrow spaces. Conclusion： OA is characterized histo logically by degeneration and proliferation of articular cartilage, associated with destroying and remodelling of the underlying bone.