超声波理疗治疗下颌骨放射性骨坏死的实验研究

The experimental research in the ultrasonic treatment to the mandibular osteoradionecrosis

目的:观察低强度超声波对下颌骨放射性骨坏死(osteoradionecrosis of the jaws,ORNJ)的治疗作用并分析其作用机理。方法:随机选取12只实验犬分为A、B、C两组,A、B二组每组5只,C组2只。A、B二组接受放射照射。C组作为正常组,不做任何处理。放射结束后1个月,拔除实验动物双侧下颌第一恒磨牙,确定局部形成ORNJ后,A组接受超声治疗20天,B组不做处理。放疗后3个月取材,通过影像学骨密度检查和病理学观察,比较A、B二组间照射区下颌骨骨质变化。结果:影像学骨密度检查尽管A、B二组照射区骨密度都低于正常对照组动物,但经过超声治疗的实验组动物骨密度明显高于对照组。病理检查并行微血管密度免疫荧光检测,B组牙槽骨中未检测到任何血管组织,而A组中可以见到少量血管组织,但仍较C组血管密度低。结论:根据以上结果,可以初步确定低强度超声对ORNJ的愈合有促进作用。考虑到超声物理治疗的经济成本低,易于持续应用,可能有更好的长期疗效。

Objective：To observe the curative effect of ultrasonic treatment to the osteoradionecrosis of the jaws（ORNJ）.Methods： Twelve dogs were divided into 3 groups as A,B and C.There were 5 dogs in group A and B,2 dogs in group C.After 1 month radiotherapy to group A and B,the first mandibular molars in both groups were extracted to form ORNJ.Then group A was treated with physiotherapy of ultrasound for 20 days.3 months after radiotherapy,all the mandibles of three groups were taken for bone density and pathological examination to analyze the mandibular change at local sites.Results： The imaging examination of bone density showed the bone density of group A and B were all lower than normal animal in group C.However,the bone density of group A with ultrasonic treatment,was higher than group B.The immunocytological examination for microvessel dentisty observed the same results.No vessel could be found in group B,but a little vessel could be found in group A.Both were lower than group C.Conclusion： According to the result,it could be primarily concluded that the ultrasonic treatment could improve the healing of ORNJ.Concerning the low cost of ultrasonic physiotherapy,it is suitable to be applied in patients for long time with better prognosis.