兔泪小管断裂损伤修复的实验研究

发布时间：2018-04-16 19:13

本文选题：泪小管断裂 + 动物模型　；参考：《华中科技大学》2012年硕士论文

【摘要】：目的通过建立兔泪小管断裂吻合联合置管的动物模型，观察术后不同时间点兔泪小管断裂后吻合口的病理变化及细胞增生情况，，探讨泪道置管的最佳拔管时间。方法距泪点3mm切断泪小管制作兔泪小管断裂损伤动物模型。采用完全随机方法将16只兔(32眼)分成A、B、C三组。A组为正常对照组2只兔（4眼）；B组单纯吻合对照组2只兔(4眼)，吻合泪小管但不置管；C组为实验组12只兔(24眼)：吻合泪小管联合置管组，再根据术后不同时间点（1月、2月、3月）拔管再分为3个亚组，每亚组4只兔8眼。术后4月，A、B组和C组各亚组2只兔(4眼)均行泪道冲洗检查，泪道内窥镜检查了解泪道粘膜情况，组织学病理学检查观察吻合口区病理变化及细胞增生情况。C组各亚组拔管时间点2只兔(4眼)亦进行泪道冲洗、泪道内窥镜检查和组织学病理学检查，并与术后4月结果对比。结果A组正常对照组（4眼）泪道冲洗均通畅；泪道内窥镜检查正常；病理学检查正常。B组（4眼）单纯吻合对照组泪道冲洗均不通；泪道内窥镜检查泪小管管壁粗糙、增厚，呈灰白色，大量无弹性的灰白色膜样物质；病理学检查泪小管粘膜上皮细胞增生，排列成多层，少量炎症细胞，上皮下结构基本正常。C组吻合联合置管实验组，术后1月拔管亚组（4眼）拔管时泪道冲洗3眼通畅，1眼不通；泪道内窥镜检查粘膜呈淡粉红色，管壁略粗糙，有少许膜样物质飘浮在泪小管内；病理学检查粘膜上皮细胞基本正常，管腔正常，部分上皮层脱落，上皮下结缔组织增生。术后2月拔管亚组（4眼）拔管时泪道冲洗1眼通畅，3眼不通；泪道内窥镜检查泪小管粘膜呈粉红色，可见出血点，管腔狭窄，管壁见苍白色瘢痕，泪小管内可见大量膜样物质飘浮；病理学检查粘膜上皮细胞增生，管腔有部分狭窄，上皮下可见结缔组织增生。术后3月拔管亚组（4眼）拔管时泪道冲洗3眼通畅，2眼狭窄，1眼不通；泪道内窥镜检查粘膜呈粉红色，管腔肥厚，狭窄，有大量粉红色模样物质；病理学检查泪小管上皮细胞增生，管腔正常，上皮下结构尚正常。C组各亚组术后4月时泪道冲洗检查，泪道内窥镜检查和组织学病理学检查与拔管时相比基本相同。结论兔泪小管断裂损伤选择吻合联合置管术，术后1月拔管为宜，置管2月、3月瘢痕增生较1月明显。
[Abstract]:Objective to establish an animal model of lacrimal canaliculus anastomosis and to observe the pathological changes and cell proliferation of lacrimal canaliculus after lacrimal canaliculus rupture at different time points, and to explore the optimal extubation time of lacrimal canaliculus.Methods the lacrimal canaliculus was cut off by 3mm from lacrimal point to make rabbit lacrimal canaliculus injury model.16 rabbits (32 eyes) were randomly divided into three groups: group A: normal control group (n = 2); group B: simple anastomosis of control group (n = 2); group C: group C (n = 12): anastomosis of lacrimal canaliculi but without tubules; group C (n = 12);Lacrimal canaliculus combined catheterization group,According to the different time points (1, 2, 3 months), the extubation was subdivided into 3 subgroups, 4 rabbits in each subgroup (8 eyes).Four months after operation, lacrimal passage irrigation was performed in 2 rabbits in group B and group C) and lacrimal duct mucosa was examined by endoscopy.Histopathological examination: histopathological changes and cell proliferation in anastomotic area. Group C (4 eyes) were treated with lacrimal passage irrigation, endoscopy and histopathology, and the results were compared with those of 4 months after operation.Results in group A, lacrimal passage irrigation was smooth in 4 eyes of normal control group; endoscopy of lacrimal duct was normal; pathological examination was normal in 4 eyes of group B) the lacrimal duct wall was coarse and thickened by endoscopy of lacrimal duct, and lacrimal duct wall was coarse and thickened by endoscopy of lacrimal duct.The epithelium of the lacrimal tubule was proliferated and arranged into multiple layers, a small number of inflammatory cells, and the subepithelial structure was basically normal.1 month after the extubation, 4 eyes in the extubation group) 3 eyes had lacrimal passage irrigation and 1 eye was impassable during extubation, the mucosa of lacrimal duct was light pink, the wall of the tube was slightly rough, and a little membrane-like substance was floating in the lacrimal duct.Pathological examination showed that the mucosal epithelial cells were normal, the lumen was normal, part of the epithelium was exfoliated, and the epithelium was proliferating.2 months after extubation, 4 eyes in the extubation group (4 eyes) had lacrimal passage irrigation in 1 eye and 3 eyes in the extubation group. Endoscopy of lacrimal duct showed that the mucous membrane of lacrimal canaliculus was pink, bleeding point was visible, lumen was narrow, and pale white scar was seen on the wall of the tube.A large number of membrane-like substances could be seen floating in the lacrimal tubule. Pathological examination showed that the mucosal epithelial cells proliferated, the lumen was partly narrow, and the connective tissue proliferation was seen in the upper subcutaneous layer.3 months after the extubation, 3 eyes of the extubation group (4 eyes), 3 eyes of the lacrimal passage irrigated unobstructed and 2 eyes with stenosis and 1 eye obstruction, the mucous membrane of the lacrimal duct was pink, the lumen was hypertrophic and narrow, and there were a lot of pink appearance material.The epithelial cells of lacrimal tubules proliferated and the lumen of lacrimal tubules were normal. The lacrimal passage irrigation examination, endoscopy examination and histopathological examination of lacrimal duct were similar to those of extubation 4 months after operation in group C.Conclusion the canaliculus fracture injury in rabbits was combined with anastomosis and extubation at one month after operation. The scar hyperplasia in 2 months and 3 months was more obvious than that in 1 month.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.6

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