中文摘要：

目的探讨犬喉自体脂肪及筋膜植入后植入组织生长特性、填充机制及影响填充效果的因素。方法16只犬32侧声带，除2侧声带作为正常对照组不作任何手术处理外，其余30侧声带通过切断喉返神经建立声带麻痹动物模型后，分为以下4组：脂肪注射组（10侧）、脂肪填充组（5侧）、筋膜注射组（8侧）、筋膜填充组（7侧），除筋膜填充组填充于犬声带的固有层外，其余三组脂肪和筋膜注射分别注射于犬喉的声门旁间隙，于术后第1周、1、3、6、12个月对犬喉植入的脂肪、筋膜分别进行大体及组织病理学观察及比较。结果脂肪植入组在脂肪植入部位可见炎性细胞浸润，于术后第3个月后消失，术后3月时开始有新生血管形成，12月时脂肪植入部位仍可见团状的成活脂肪细胞。筋膜植入组无明显炎性细胞反应，在筋膜植入部位，筋膜组织以密度较高的纤维组织形式存在，均于第1个月时观察到纤维母细胞，筋膜填充组术后第3个月后筋膜组织呈均匀排列，第6个月后椭圆形纤维母细胞密度增大，填充部位新生血管形成，术后12个月其密度与周围组织趋于一致。脂肪植入组纤维母细胞出现比例（4／15）小于筋膜植入组（9／15），而新生血管比例（7／15）大于筋膜植入组（3／15）。结论自体脂肪及筋膜作为声带填充材料具有良好的组织相容性，术后12月时仍在植入部位存活。填充物周围纤维包膜的形成及植入后纤维组织、纤维母细胞、自体血管等的生长，对保持填充效果长期稳定有影响。

英文摘要：

Objective Study the characteristics of transplanted fat and fascia graft in vocal fold medialization in order to investigate the mechanism and explore the choice of graft for vocal fold medialization. Methods Thirty two vocal folds from 16 dogs including 2 normal controls were used and classified into 3 groups：①as having fat in- jection or transplantation to the paraglotic space after glottic paralysis②fascia injection to the paraglotic space after glottic paralysis and ③fascia transplantation to vocal fold lamina. The characteristics of different graft and patholog- ical mechanism were evaluated by histopathological examination at 1 week, lmonth, 3months, 6months and 12months after surgery. Results There was inflammatory reaction in fat 3 months after the suryery. Neovascular- ization was found in group Fat Injection in 3 months after surgery, with a tiny fibrotic capsule surrounding the graft. There was competent fat after fat implanted in 12 months. While fascia grafts were with little inflammatory reaction. Fascia graft included fibroblast and fibrous tissue 1 month after surgery. Fibrogenesis decreased after 3 months in group Fascial Transplantation, Neovascularization and fibroblast were abundant 6 months after surgery. Fibro densitybecame same as the vocal fold lamina 12 months after surgery. Fibroblast was found in group FAT （4/15） and in group FAS （9/15）. Neovascularization was found in group FAT （7/15） and in group FAS （3/15）. Conclusion Autolo- gous fascia and fat graft had a good biocompatibility. Fibroblast, neovascularization and fibrogenesis fibrotic capsule surrounding the material were important to retain the volume of vocal folds.