论文部分内容阅读
目的:探讨颞下颌关节(TMJ)盘锚固术中游离脂肪组织瓣移植预防黏连的效果。方法:选取3个月龄小型猪6只,将左侧作为实验组,对其进行关节盘前附着松解,并切取耳前区脂肪瓣,移植到松解后的间隙内。右侧作为对照组,只进行关节盘前附着松解。术前,术后3、6个月分别测其最大被动开口度,术后3、6个月各处死3只动物,取关节标本,分别进行HE染色和Masson染色,观察有无黏连形成。采用SPSS16.0软件包对测量数据进行Wilcoxon符号秩和检验。结果:与术前相比,小型猪的最大被动开口度在术后3个月、6个月逐步减少,差异显著(P<0.01)。开口型不同程度地偏向右侧。HE染色显示,实验侧关节表面光滑,无黏连形成;对照侧关节术后3个月滑膜表面充血明显,有细小的黏连形成;术后6个月可见致密的纤维结缔组织。Masson染色显示,对照侧黏连组织中可见致密的胶原及弹力纤维,其内偶见小血管。结论:在TMJ盘锚固术中,游离脂肪瓣能较好地预防纤维黏连形成,值得推广应用。
Objective: To investigate the effect of free fatty tissue flap transplantation in the prevention and treatment of temporomandibular joint (TMJ) disk anchorage. Methods: Six miniature pigs of 3 months old were selected, the left side was taken as the experimental group, and their anterior disc was detached and attached. The anterior part of the fat flap was excised and transplanted into the clearance after release. The right side as a control group, only the pre-disc attachment and release. The maximal passive open degree was measured preoperatively and 3 and 6 months after operation. Three animals were sacrificed 3 and 6 months after operation respectively. Tissue specimens were obtained and stained with HE and Masson respectively to observe the formation of adhesions. SPSS16.0 software package was used to measure the data Wilcoxon signed rank sum test. Results: Compared with preoperative, the maximal passive open degree of miniature pigs decreased gradually at 3 months and 6 months after operation, with significant difference (P <0.01). The open type is biased to the right to varying degrees. Hematoxylin and eosin (HE) staining showed that the surface of experimental joint was smooth and no adhesions formed. The surface of synovial membrane was hyperemicuated 3 months after operation in the control side joint, with small adhesions forming. The dense fibrous connective tissue was seen 6 months after operation. Masson staining showed that dense collagen and elastic fibers were seen in the adhesive layer on the control side, with occasional small blood vessels therein. Conclusion: In the TMJ plate anchoring, free fat flap can better prevent the formation of fiber adhesion, which is worth popularizing and applying.