应用牵张成骨技术修复腭裂的动物实验研究

Distraction osteogenesis for correction of cleft palate: an experimental study in dogs

目的:将DO技术应用于腭裂硬腭裂隙关闭,以探索一种硬腭部分成骨性修复的新方法,从而达到腭裂功能性整复的目的。方法:以1-1.5岁杂种大7只为研究对象,建立人工腭裂的动物模型。2只为对照组,只在硬腭后部形成8mm×30mm全层洞穿缺损裂隙,5只在形成缺损的同时安置DO装置,并形成骨转移盘,术后12天开始以每次0.3mm,每日2次向裂隙一侧牵张移动骨转移盘,至硬腭部软硬组织裂隙完全关闭,10周后处死动物行大体标本观察照相及X线摄片。结果:对照组10周后处死观察裂隙大小形态与手术时无差别,实验组DO装置固定牢靠、无松脱、顺利完成牵张过程,硬腭部裂隙完全关闭,骨标本及X线片示牵张区完全为新生骨组织取代,骨质厚度约0.5-1.0mm。结论:自行设计的牵张器具有稳定可靠的牵张作用,经牵张成骨能成功地完成硬腭缺损骨性修复,从而为腭裂修复提供了一种新的途径。

Objective To explore a new method to forming osseous repairing of hard palate partially, distraction os-teogenesis(DO) technique was applied to close the cleft palate in order to complete the functional repairing of cleft palate. Methods Select seven mongrel dogs of 1 to 1.5-year-old as the animal model of surgical cleft palate, in which two dogs were treated as controls and others belong to experimental group. A complete perforative cleft was established in every dog, however, transport disc was produced while DO devices were fixed in the experimental group. From 12 days of postoperation, the transport disc was distracted from one side of cleft to the other side with the frequency of 2 times a day and with the rate of 0.3mm once. After 10 weeks these animals were killed, X-ray and morphologic observation were carried out. Results The dimensions of the cleft in the control group made little changes from postoperation. As a contrast in the experimental group,the DO devices were fixed stably, the clefts were closed completely, a new bone formation that has the thickness of 0.5-1.0mm exists in the distraction zone through the observation of X-ray and morphology. Conclusion In this study, the self-designed DO equipments showed stable and reliable effects of distraction. DO technique completed the bony repairing of defect in hard palate successfully, which provides a new way to repair the cleft palate and great significance for the development of voice and maxillary bone of the relevant patients.