论文部分内容阅读
目的:探讨人脱细胞羊膜(HAM)移植物用于兔膀胱重建的效果。方法:用物理和酶消化方法制备人脱细胞羊膜,将12只兔行半个膀胱切除后用人脱细胞羊膜移植物进行修补,另外6只兔行半个膀胱切除后单纯缝合作为对照。分别于术后2、4、8周测定膀胱容量并取膀胱进行组织学观察。结果:应用人脱细胞羊膜行兔膀胱重建术后,实验组与对照组2、4、8周膀胱最大容量(Volmax)比较差异有显著性(P<0.05)。与术前相比,实验组和对照组膀胱容量均缩小,差异有显著性(P<0.05和P<0.01)。组织学观察,2周时人脱细胞羊膜即已吸收降解,膀胱移行细胞和平滑肌细胞开始形成,炎性反应明显;4、8周后膀胱的三层结构明显,炎性反应轻微,接近正常兔膀胱。而对照组仅2周时有轻微炎性反应,4、8周炎性反应消失。膀胱三层结构均正常。实验组大多数重建膀胱均有结石形成(8/11),对照组仅1例结石形成(1/6)。结论:人脱细胞羊膜作为膀胱移植物进行膀胱修补吸收降解迅速,移行细胞和膀胱平滑肌细胞可在移植物支架上再生,可以用做组织工程膀胱的支架材料进一步研究。
Objective: To investigate the effect of human acellular amniotic membrane (HAM) graft on bladder reconstruction in rabbits. Methods: The human amniotic membrane was prepared by physical and enzymatic digestion. Twelve of 12 rabbits were repaired with human acellular amniotic membrane graft after half cystectomy. The other 6 rabbits were stitched as a control after half cystectomy. The bladder capacity was measured at 2, 4, and 8 weeks after operation and the bladder was taken for histological observation. Results: After bladder debridement was performed using human amniotic membrane in rabbits, the maximal volume of bladder (Volmax) at 2, 4 and 8 weeks in experimental group and control group were significantly different (P <0.05). Compared with the preoperative, the experimental group and the control group bladder capacity were reduced, the difference was significant (P <0.05 and P <0.01). Histological observation showed that after 2 weeks, human decellularized amniotic membrane had absorbed and degraded, bladder transitional cells and smooth muscle cells began to form, and the inflammatory reaction was obvious. After 4 and 8 weeks, the three-layer structure of the bladder was obvious with slight inflammatory reaction and close to normal rabbit bladder. In the control group, there was a slight inflammatory reaction in only 2 weeks, and the inflammatory reaction disappeared in 4 and 8 weeks. Three layers of bladder structure are normal. Most of the bladder reconstruction in the experimental group had stones (8/11), while in the control group only 1 stone (1/6) formed. CONCLUSION: Human decellularized amniotic membrane can be used as a bladder graft for bladder repair and absorption to degrade rapidly. Transitional cells and bladder smooth muscle cells can be regenerated on the scaffolds of the grafts, which can be used as scaffolds for bladder tissue engineering.