带胸大肌蒂的胸骨膜修复气管的实验研究

Repair of tracheal defect with autologous pectoralis major myoperiosteal flap in rabbits

目的 :研究胸大肌肌蒂胸骨膜修复气管成骨情况。方法 :选用 15只兔 ,左侧带胸大肌蒂的胸骨膜修复颈段气管下部 0 .4cm× 0 .6cm全层气管壁缺损。右侧游离胸骨膜修复颈段气管上部相同大小气管壁的缺损 ,为对照组。分别于术后第 2、4、8、12、2 4周处死动物。光镜观察移植物成骨情况。结果 :实验组 ,术后 12周移植部再生出成熟软骨团块 ,2 4周形成骨质填充于气管缺损区。对照组 ,2 4周仅有小岛状新生软骨。两组成骨厚度和长度均有显著差异 (p <0 .0 5 )。结论 :带胸大肌蒂的胸骨膜修复气道能再生出新的骨质 。

Objective: To evaluate pectoralis major myoperiosteal flap for repair of a cervical tracheal defect. Methods: Two tracheal defects(0.4cm×0.6cm)were repaired with free or musculi pectoralis major pedicellated sternoperiosteum in 15 adult rabbits. A group of free grafts was used for control. The animals were sacrificed respectively at the 2nd, 4th, 8th, 12th, 24th week after operation and the tracheas were harvested for light microscope study. Results: At the 2nd week, surfaces of tracheal defect were completely covered by epithelium. At the 12th week, new cartilage was observed at the site of grafts in the experiment group. At the 24th week, the graft produced new bone, and the defects were repaired by new cartilage and bone, nevertheless the contrasts only regenerated a few small islands of new cartilage. There was a significant difference between the experimental and control groups on the thickness and length of new cartilages and bones (p<0.05). Conclusion: The pectoralis major myoperiosteal flap has ability to regenerate bone and cartilage and is available for laryngotracheal reconstruction.