摘要
目的通过对动物模型喉返神经损伤后环杓关节组织病理学特点研究，探讨喉返神经损伤后环杓关节结构及功能的变化特点。方法喉返神经不同损伤（全切、半切、结扎及挫灭）模型及正常对照犬共16只（32侧半喉，其中8侧为正常对照），于损伤后1个月、3个月、6个月、12个月进行环杓关节组织病理研究。结果喉返神经损伤后，环杓关节可呈现出不同程度的纤维蛋白渗出（12／24）、关节面纤维膜破裂（9／24）、纤维增生（7／24）、关节软骨退行性变（3／24）等表现。损伤后1个月主要是纤维蛋白渗出及关节面纤维膜的破裂；损伤后3个月主要表现为关节面纤维膜的破裂；损伤后6个月各种组织病理改变均出现，开始出现关节腔纤维增生及关节软骨的退行性变；损伤后12个月以纤维增生出现比例最高，但纤维化所占面积未超过关节面50．0％。仅全切组及结扎组出现环杓关节纤维增生及杓状软骨的退行性变，全切组及结扎组纤维化比率与正常对照组差异有统计学意义（t值分别为6．23及3．65，P值均〈0．01）；全切组环杓关节平均软骨细胞核数与正常对照组间差异有统计学意义（t=2．78，P〈0．05）。半切组和挫灭组的表现基本一致，病理变化程度轻。纤维增生（7侧次）与关节软骨退行性改变（3侧次）只在9侧声带麻痹加重及未恢复组出现（其中1侧标本存在两种病变），预后不良。结论环杓关节病理变化程度与神经损伤程度一致，全切组及结扎组出现的病理变化较重，且在喉返神经损伤后6个月已有表现。
Objective To investigate the histopathological changes in cricoarytenoid joints in 32 animal models. The characteristic histopathological changes of arytenoid cartilages after recurrent nerve paralysis were evaluated. Methods Sixteen dogs （32 vocal folds, 8 as norulal control） were divided into different animal models of recurrent nerve paralysis as transection, half - section, ligation, or crush. The histopathological finds of arytenoid cartilages were analysed. Results Arytenoid cartilages showed fibrin （ 12/24 ）, disruption of the fibrous membrane （ 9/24 ）, fibrillation （ 7/24 ） and degenerative changes in their joint surface structure （3/24） at various levels of intensity. The fibrin and disruption of the fibrous membrane were found 1 month after injury, and all changes appeared in 6 months. The fibrillation and arytenoid cartilages degenerative changes revealed in transaction group and ligation group, and became stronger in time of 6 months. The correlation among the fibrillation ratio and the normal control was positive （ t were 6.23 and 3.65, P 〈 0.01 ）. The correlation among the number of cellular of arytenoid cartilages and the normal control was positive （ t = 2.78, P 〈 0.05 ）. The fibrillation （ 7 ） and arytenoid cartilages degenerative changes （3） revealed in vocal fold fixation to influence the recovery of laryngeal function. Conclusions The histopathological change of cricoarytenoid joint after recurrent nerve paralysis was related to the severity of neural injury. Influence the recovery of laryngeal function more often from 6 months.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2010年第1期56-60,共5页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
声带麻痹
喉返神经
发音障碍
疾病模型
动物
狗
Vocal cord paralysis
Recurrent laryngeal nerve
Articulation disorders
Disease models, animal
Dogs
