腮腺术中脱细胞异体真皮基质植入预防Frey's综合征动物实验研究

Observation of acellar dermal matrix implantation in the surgical field of parotidectomy

目的探讨腮腺手术中以不同方式植入脱细胞异体真皮基质的中长期变化。方法20只新西兰大白兔随机分为3月、6月、9月、12月组(每组5只),建立腮腺手术中将脱细胞异体真皮基质以正、反两种方向植入的模型。对模型进行临床和病理观察。结果①新生血管在脱细胞异体真皮基质中呈单向性生长。腮腺术中反向植入补片时,脱细胞异体真皮基质与面神经之间瘢痕粘连不紧密,易于分离。②脱细胞异体真皮基质愈合时,血管、神经纤维都可长入,并最终布满全层。结论①腮腺手术中反向植入脱细胞异体真皮基质,因其与面神经之间瘢痕粘连不紧密且易于分离,这将有利于防止二次手术时损伤面神经。②在本研究中,脱细胞异体真皮基质不能阻止神经纤维的长入。所以其预防Frey's综合征的持久性有待进一步观察。

Objective To investigate the long-time changes of acellular dermal matrix（ADM） implanted into the surgical field after parotidectomy in different ways.Methods Twenty New Zealand white rabbits were used as animal model and randomly divided into 4 groups（n = 5）.Parotid gland surgery was established and ADM film was implanted in all the four groups.Animals were sacrificed every 3 months after surgery for pathological observation.Results The rough side of ADM film can be attached and combined with tissues well,while the smooth side of which can not be attached.Conclusion Since ADM can be combined with nerve fibers,the long-term prevention from Frey＇s syndrome by surgical implantation of ADM in parotid gland might be limited.However,this study also indicated that reverse implantation of the ADM film can be conducive to parotid second surgery,for it can possibly prevent facial nerve injury.