目的: 针对目前小儿颅骨缺损的多种治疗观念及课题组前期研究提出的“滑行理论”,利用幼龄SD大鼠模型探究颅骨缺损及钛网修补后对其颅骨生长和智力发育的影响。方法: 将3周幼龄SD大鼠随机分成假手术对照组(SOC)、颅骨缺损组(SD)和钛网修补组(TMR),术前排除组间差异,术后同环境下饲养至性成熟进行旷场实验和Morris水迷宫实验后处死,测量体质量、颅骨径线、颅骨厚度、缺损内径和脑容积等指标。结果: 术前体质量及颅骨径线显示三组间差异无统计学意义(P＞0.05),具有可比性;性成熟时体质量、颅骨径线、脑容积三组间均无差异(P＞0.05),仅SOC组平均颅骨厚度较大(P＜0.05);缺损内径方面SD组与TMR组无差异(P＞0.05),且与术前相比均呈狭长形变;旷场实验中总路程、平均速度和静止时间及部分区域数据方面SD组与其他组有差异(P＜0.05);Morris水迷宫实验显示第5天逃避潜伏期、首次穿越平台时间和目标象限时间占比等SD组与其他组均有差异(P＜0.05)。结论: 颅骨缺损未行修补对幼龄大鼠颅骨的正常生长无明显影响,但可能影响其智力发育;钛网修补并不会限制幼龄颅骨的生长,反而避免了未行修补可能对智力发育的不利,丰富了“滑行理论”的同时为小儿颅骨缺损的“早期修补观念”提供了一定的依据。
Objective: To explore effects of skull defect and titanium mesh repair on skull growth and intelligence development in juvenile rats. Methods: 3-week-old SD rats were randomly divided into the sham operation control group (SOC group), skull defect group (SD group) and titanium mesh repair group (TMR group). Differences among the three groups were excluded before surgery. Rats were reared to sexual maturity in the same environment for open field test and Morris water maze test after operation, and then sacrificed. The body weight, skull line, skull thickness, defect diameter and brain volume were measured. Results: Body weight and skull diameter line showed no statistical difference among the three groups before operation (P＞0.05), and they were comparable. There were no differences on body weight, skull line and brain volume at the time of sexual maturity among the three groups (P＞0.05). Only the average thickness of rats in the SOC group was slightly thicker than the other two groups (P＜0.05). There was no difference between the SD group and TMR group in terms of the inner diameter of skull defect (P＞0.05), and the defects were elongated comparing with that before operation. By comparing the SD group and the other two groups, differences in terms of total distance, average speed and quiescent time were found in the open field experiment (P＜0.05). Morris water maze test showed that there were differences between SD group and other groups in terms of escape latency on day 5, first crossing platform time and proportion of target quadrant time (P＜0.05). Conclusions: The unrepaired skull defect had no obvious effect on the normal growth of skull in juvenile rats, but might affect their intellectual development. Titanium mesh repair does not limit the skull growth of juvenile rats, and could avoid the possible native influence to the intellectual development in rats with skull defect without repair. Reliable evidence to Repair Skull Defect Early in Children was provided in this study and the Gliding Theory enriched.
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