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目的通过观察先天性腭裂山羊模型,研究不同时期宫内修复对山羊面中部发育的影响。方法取24只8～12月龄雌性杂交波尔山羊,体重35～55kg,以配种日期定为孕0d,于孕30d经B超确认怀孕后随机将实验动物分为5组。取其中20只分别于孕31～42d肌肉注射左旋毒藜碱(15mg/d)制备先天性腭裂动物模型;其余4只作为正常对照组不作处理,待其正常生产。20只实验动物模型形成后随机分为实验1、2、3、4组(n=5),前3组分别于孕65、90、120d采用改良兰氏法对宫内1只胎羊行腭裂修复术;实验4组作为未修复对照组。小羊出生后1个月,采用CT颅面测量技术,测量上颌最前磨牙前方的两侧凹陷处间距(posterior premolar morphological measurement,PPMM),及以此线为基准测量上颌骨最前点至此线的垂直距离(anterior premolar morphological measurement,APMM),最后制作干颅行大体观察。结果小羊出生后1个月,实验1组PPMM、APMM与正常对照组比较差异均无统计学意义(P>0.05),与实验4组比较差异均有统计学意义(P<0.05);实验2组PPMM、APMM与正常对照组、实验4组比较差异均有统计学意义(P<0.05);实验3组PPMM与正常对照组和实验4组比较差异均有统计学意义(P<0.05),APMM与正常对照组比较差异有统计学意义(P<0.05),但与实验4组比较差异无统计学意义(P>0.05)。实验4组的5只腭裂小羊仅存活1～2个月。结论对孕65d胎羊行宫内修复腭裂后对面中部发育影响最小,越接近孕晚期修复对面中部发育影响越大,但修复手术越早流产风险越高。
Objective To observe the effects of intrauterine repair in different periods on goat midface development by observing the goat model of congenital cleft palate. Methods Twenty-four female hybrid goats aged 8 to 12 months weighing 35-55 kg were enrolled in this study. Pregnant 0 days were assigned to the mating date. Pregnant animals were randomly divided into 5 groups on the 30th day after pregnancy. Twenty of them were injected intramuscularly with L-toxin (15mg / d) during 31-42 d of pregnancy to prepare congenital cleft palate animal model. The other four rats were treated as normal control group without any treatment until their normal production. Twenty experimental animal models were randomly divided into experimental groups 1, 2, 3, and 4 (n = 5). The first three groups were treated with modified Rankine’s method at 65, 90, Repair; experimental group 4 as the uncorrected control group. One month after the birth of the lamb, the posterior premolar morphological measurement (PPMM) was measured in front of the maxillary maxillary molars using CT craniofacial measurement, and the vertical line of the maxillary anterior to this line was measured Distance (anterior premolar morphological measurement, APMM), the final production of dry skull general observation. Results There was no significant difference in PPMM and APMM between experimental group 1 and normal control one month after birth (P> 0.05), and there was significant difference between experimental group 1 and experimental group 4 (P <0.05) The difference between PPMM and APMM in two groups was statistically significant (P <0.05). The PPMM in experimental group 3 was significantly different from that in normal control group and experimental group 4 (P <0.05) There was significant difference between APMM and normal control group (P <0.05), but there was no significant difference between APMM and experimental group (P> 0.05). Five cleft palate lambs in experimental group 4 survived only for 1 to 2 months. Conclusion The results showed that the effect of intrauterine repair of cleft palate on the development of the middle part of the fetus was the smallest. The closer to the third trimester, the greater the influence on the midface and middle part. However, the earlier the repair operation, the higher the risk of miscarriage.