三種新型復合材料修補大鼠腹壁缺損的研究_《中國普外基礎與臨床雜志》

作者：

丁國飛 ¹ , 田文 ¹ , 姚京 ² , 李佳 ¹ , 鄭亞杰 ¹ , 楊松 ¹

1.中國人民解放軍總醫院普外科(北京 100853);;
2.中國人民解放軍總醫院第一附屬醫院普外科(北京 100857);

關鍵詞：

腹壁缺損可吸收材料大鼠

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目的觀察三種新型國產復合補片修補腹壁缺損的效果，客觀評價三種補片的防粘連效果。方法Wistar大鼠120只，采用完全隨機方法隨機分為4組: ①聚丙烯(PP)+聚丙交己內酯(PLC)組; ②PP+透明質酸(HA)/PLC組; ③PP+膠原/PLC組; ④PP+膨體聚四氟乙烯(e-PTFE)組，每組30只。切除直徑約1 cm的大鼠全層腹壁，以直徑1.5 cm的補片進行修補，分別于術后30、60、90及180 d處死，每次處死5只，根據Nair評分標準進行粘連評分，并進行組織學檢查。結果術后各組大鼠均未出現死亡，在各時間點均出現腹腔粘連，主要為網膜、腸管。術后各時間點，PP+膠原/PLC組粘連評分均低于PP+e-PTFE組(P lt;0.05)。PP+HA/PLC組和PP+PLC組粘連評分與PP+e-PTFE組相比差異無統計學意義(P gt;0.05)。組織學檢查顯示，術后各時間點，各組補片周圍均有炎性細胞浸潤和成纖維細胞出現及膠原分泌，隨時間推移炎癥細胞逐漸減少，成纖維細胞逐漸增多，膠原分泌增多。術后30 d 膠原及HA層消失，PLC層出現斷裂，在術后180 d PLC層尚未被完全吸收，在4種補片腹腔面均有細胞或組織覆蓋，將補片與腹腔內容物隔離，膠原/PLC復合補片的隔離層的連續性最好。結論PLC、HA/PLC和膠原/PLC三種國產復合補片在動物實驗中均具有良好的防粘連效果，其中膠原/PLC復合補片的防粘連效果最佳，且價格低廉，適于大眾普遍使用，臨床應用前景良好。

引用本文： 丁國飛,田文,姚京,李佳,鄭亞杰,楊松. 三種新型復合材料修補大鼠腹壁缺損的研究. 中國普外基礎與臨床雜志, 2011, 18(10): 1049-1053. doi: 復制

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14.	李基業. 疝修補材料類型及有關并發癥 [J]. 臨床外科雜志, 2006, 11(11): 687689.
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16.	Chen WY, Abatangelo G. Functions of hyaluronan in wound repair [J]. Wound Repair Regen, 1999, 7(2): 7989.
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18.	張廣明. 生物可降解聚乳酸己內酯無規共聚物輸尿管支架管的制備及實驗研究 [D]. 四川大學, 2006: 1520.
19.	Kaleya RN. Evaluation of implant/host tissue interactions following intraperitoneal implantation of porcine dermal collagen prosthesis in the rat [J]. Springer Paris, 2005, 3(9): 269276.
20.	PetterPuchner AH, Fortelny RH, Glaser KS, et al. Collagen implants in inguinal and ventral hernia repair [J]. J Invest Surg, 2010, 23(5): 280284.
21.	Parker DM, Armstrong PJ, Frizzi JD, et al. Porcine dermal collagen (permacol) for abdominal wall reconstruction [J]. Curr Surg, 2006, 63(4): 255258.
22.	van’t Riet M, de Vos van Steenwijk PJ, Bonthuis F, et al. Prevention of adhesion to prosthetic mesh: comparison of different barriers using an incisional hernia model [J]. Ann Surg, 2003, 237(1): 123128.
23.	Greenawalt KE, Butler TJ, Rowe EA, et al. Evaluation of sepramesh biosurgical composite in a rabbit hernia repair model [J]. J Surg Res, 2000, 94(2): 9298.
24.	Ferrando JM, Vidal J, Armengol M, et al. Experimental evaluation of a new layered prosthesis exhibiting a low tensile modulus of elasticity: longterm integration response within the rat abdominal wall [J]. World J Surg, 2002, 26(4): 409415.

1. Matthews BD, Pratt BL, Pollinger HS, et al. Assessment of adhesion formation to intraabdominal polypropylene mesh and polytetrafluoroethylene mesh [J]. J Surg Res, 2003, 114(2): 126132.
2. 楊曉旭, 魯建國, 陸美嬌, 等. 聚丙烯補片與脫細胞真皮基質補片及傳統方法修復戰傷性腹壁軟組織缺損的比較 [J]. 中國組織工程與臨床康復, 2009, 13(29): 56535656.
3. Rohrich RJ, Reagan BJ, Adams WP, et al. Early results of vermilion lip augmentation using acellular allogeneic dermis: an adjunct in facial rejuvenation [J]. Plast Reconstr Surg, 2000, 105(1): 409416.
4. Clayman MA, Clayman LZ. Use of AlloDerm as a barrier to treat chronic Frey’s syndrome [J]. Otolaryngol Head Neck Surg, 2001, 124(6): 687.
5. Choe JM, Kothandapani R, James L, et al. Autologous, cadaveric, and synthetic materials used in sling surgery: comparative biomechanical analysis [J]. Urology, 2001, 58(3): 482486.
6. Silverman RP, Li EN, Holton LH 3rd, et al. Ventral hernia repair using allogenic acellular dermal matrix in a swine model [J]. Hernia, 2004, 8(4): 336342.
7. 中華人民共和國科學技術部. 關于善待實驗動物的指導性意見 [Z]. 2007: 20062009.
8. Nair SK, Bhat IK, Aurora AL. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions [J]. Arch Surg, 1974, 108(6): 849853.
9. Gaertner WB, Bonsack ME, Delaney JP. Visceral adhesions to hernia prostheses [J]. Hernia, 2010, 14(4): 375381.
10. Baptista ML, Bonsack ME, Felemovicius I, et al. Abdominal adhesions to prosthetic mesh evaluated by laparoscopy and electron microscopy [J]. J Am Coll Surg, 2000, 190(3): 271280.
11. Asano T, Takazawa R, Yamato M, et al. Transplantation of an autologous mesothelial cell sheet prepared from tunica vaginalis prevents postoperative adhesions in a canine model [J]. Tissue Eng, 2006, 12(9): 26292637.
12. Bauer JJ, Salky BA, Gelernt IM, et al. Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE) [J]. Ann Surg, 1987, 206(6): 765769.
13. Matthews BD, Pratt BL, Pollinger HS, et al. Assessment of adhesion formation to intraabdominal polypropylene mesh and polytetrafluoroethylene mesh [J]. J Surg Res, 2003, 114(2): 126132.
14. 李基業. 疝修補材料類型及有關并發癥 [J]. 臨床外科雜志, 2006, 11(11): 687689.
15. 凌沛學, 管華詩. 透明質酸及其衍生物防粘連的研究與應用 [J]. 中國藥學雜志, 2005, 40(20): 15271530.
16. Chen WY, Abatangelo G. Functions of hyaluronan in wound repair [J]. Wound Repair Regen, 1999, 7(2): 7989.
17. 張仲文, 徐莘香, 周莉, 等. 聚己內酯/聚乳酸薄膜防治肌腱粘連的實驗研究 [J]. 中華骨科雜志, 1998, 11(11): 692694.
18. 張廣明. 生物可降解聚乳酸己內酯無規共聚物輸尿管支架管的制備及實驗研究 [D]. 四川大學, 2006: 1520.
19. Kaleya RN. Evaluation of implant/host tissue interactions following intraperitoneal implantation of porcine dermal collagen prosthesis in the rat [J]. Springer Paris, 2005, 3(9): 269276.
20. PetterPuchner AH, Fortelny RH, Glaser KS, et al. Collagen implants in inguinal and ventral hernia repair [J]. J Invest Surg, 2010, 23(5): 280284.
21. Parker DM, Armstrong PJ, Frizzi JD, et al. Porcine dermal collagen (permacol) for abdominal wall reconstruction [J]. Curr Surg, 2006, 63(4): 255258.
22. van’t Riet M, de Vos van Steenwijk PJ, Bonthuis F, et al. Prevention of adhesion to prosthetic mesh: comparison of different barriers using an incisional hernia model [J]. Ann Surg, 2003, 237(1): 123128.
23. Greenawalt KE, Butler TJ, Rowe EA, et al. Evaluation of sepramesh biosurgical composite in a rabbit hernia repair model [J]. J Surg Res, 2000, 94(2): 9298.
24. Ferrando JM, Vidal J, Armengol M, et al. Experimental evaluation of a new layered prosthesis exhibiting a low tensile modulus of elasticity: longterm integration response within the rat abdominal wall [J]. World J Surg, 2002, 26(4): 409415.

《中國普外基礎與臨床雜志》

三種新型復合材料修補大鼠腹壁缺損的研究

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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《中國普外基礎與臨床雜志》

三種新型復合材料修補大鼠腹壁缺損的研究

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料