采用颅骨外板行颅面部植骨及其供区的组织学研究

A histological study of lamina externa cranii and its donor site after having been grafted to facies cranii area

目的:观察应用颅骨外板行颅面部植骨后植骨区及其供区的组织学变化。方法:8～12个月龄小香猪4只,截取颅顶部2.5 cm×1.0 cm大小骨块,均分为2块分别贴附移植于鼻拱部两侧,随机挑选2只动物,于术后12周处死,取颅骨外板贴附植骨区及供区各1.0 cm×0.5 cm大小骨质标本行组织学检查;另2只动物于术后24周处死,对颅骨外板供区的愈合情况行大体观察,同时取骨质标本行组织学检查。结果:植骨区:HE染色,术后12周时骨质吸收明显,术后24周时骨基质明显增多,成骨现象已不明显;扫描电镜,术后12周移植骨与受区界面尚可分辨,Ⅰ型胶原排列轻度紊乱;24周时胶原排列整齐,钙盐沉积致密均匀。供区:HE染色,术后12周可见少量新骨形成,粘合线排列较紊乱;24周时可见成骨明显,哈佛管排列较规则;扫描电镜观察,术后12周时可见局部凹凸不平,结构紊乱;24周时胶原排列整齐,钙盐沉积致密均匀。大体观可见供区创面已完全愈合,皮质骨再生但不完全,局部可见凹陷。结论:颅骨外板移植后24周组织学结构改变已基本完全;供区可达到组织结构的再生修复,但形态学上可见骨再生不完全并可见局部凹陷。

Objective： To observe the histological changes of lamina externa cranii at both the graft and donor areas after having been grafted in animal experiment. Methods： 4 mini pigs aged from 8 to 12 months were selected. Part of the outer table of skull （2.5 cm× 1.0 cm） was decorticated and was divided equally. Both were implanted on each side of the snouts of animals. 2 pigs were selected randomly and were killed 12 weeks postoperation. Each 1.0 cm×0. 5 cm specimen was harvested and histological study was performed. The other 2 animals were killed 24 weeks after operation. Gross inspection of the donor site was performed and histological study was done. Results： In the graft area： bone absorption was obvious 12 weeks postoperation, but bone matrix increased obviously at 24 weeks postoperation. Results of scanning electron microscope showed that interface between bone graft and recipient site was discernment and collagen type I was malaligned 12 weeks postoperation. Collagen fibers were in good order and good mineralization was found 24 weeks postoperation. In the donor area： small amounts of new bone formation could be seen and alignment of cemental line was chaotic 12 weeks postoperation. At 24 weeks, bone formation was obvious and alignment of haversian canal was regular. Scanning electron microscopy showed that structure of the tissue was uneven and disorder at 12 weeks postoperation. Collagen fibers were in good order and good mineralization was found 24 weeks postoperation. On gross view, raw surface of the donor site got complete healing, osteanagenesis was incomplete and introcession could be observed in the local area. Conclusion： Histological remodeling of lamina externa cranii is complete at 24 weeks after having been grafted. The donor site can regenerate but morphologic introcession could be observed.