腭裂植骨对上颌骨生长发育的影响(动物实验研究)

The influence of implantal autograft bone in total cleft palate on maxillary growth an experiment study in dogs

目的为了寻找拮抗腭裂及腭裂修复术后上颌骨生长抑制的方法，本研究观察了早期延期全裂隙植骨修复动物腭裂模型后，对上颌骨生长发育的影响。方法本研究用４０只狗作实验动物，分成正常对照组和３个实验组，实验组Ｉ外科手术造成右侧完全性腭裂，实验组Ⅱ手术造成右侧完全性腭裂后用两瓣法修补裂隙，实验组Ⅲ手术造成右侧完全性腭裂后用自体肋骨移植并用两瓣法修复裂隙。观察了上颌骨长、宽、高、后面长、宽及鼻中缝与额骨中垂线的夹角变化等指标，并进行统计学分析。结果早期的延期腭裂全裂隙骨移植修复术在拮抗裂隙和裸露骨面对上颌骨横向生长致畸作用的同时，可以诱发新的上颌骨畸形。

Objective To test the hypothesis that implant autograft bone in total cleft palate at primary cleft palate repair which may resists the disturbance of maxillary growth by cleft and denud bony wound.Methods 40 dogs were randomly divided into four groups: three control groups and one experimental group. The first control group was unoperated, the second group had a surgically created cleft palate, the third group also had a surgically created cleft palate. Using a two flap procedure immidiately, the experiment group had a surgically created cleft palate, but the palate was recontracted by implanting a piece of autograft rib bone with two flap repair. All animals were sacrificed on the 34th week after operation (43 weeks postnatal). Thirty four metricranial variables were measured directy from the cleaned skulls. Results The method is useful for maxillary growth and development by bone implant in total cleft palate. but it can cause maxillary deformity.Conclusion Clinical doctors should be cautious in using the method of primary delay bone grafting in reparing total cleft of cleft palate.