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目的:在动物模型体内研究异种(猪皮、牛心包)来源的脱细胞基质补片在盆底修复中的作用。方法:选取北京农业大学培育的中国小型实验猪13只,分成3组,将小型猪阴道黏膜前后壁全层分离,并将异种来源的脱细胞基质补片(B型牛心包来源和P型猪皮来源)和人工合成网片埋植在小型猪阴道黏膜内,制成3种材料的动物在体模型。B型、P型脱细胞基质材料(ATM)组分别在术后2、4、6、8、12周,人工合成网片(美国强生公司)组在术后2、4、8周,各1只取材,取材后进行ET-VG染色,动态观察补片在动物体内分解代谢、与周围基质相互转化的情况以及补片周围的黏膜反应等。结果:大体和组织学观察示B、P两型脱细胞基质补片在动物体内都存在降解,且大致规律相同(移植12周后基本代谢)。与ATM材料相比,人工合成网片的反应较为均一,与宿主组织较好的融合,进入网片的网眼之间,周围可见新生胶原纤维、成纤维细胞、血管和弹力纤维。结论:异种脱细胞基质补片在动物阴道黏膜埋植中存在明显降解可能是造成临床复发率高的原因之一。人工合成聚丙烯网片在动物体内无代谢,从生物力学强度方面考虑,作为盆底修复手术的材料更具优势。需调整异种脱细胞基质补片的降解率,以适应盆底修复手术要求。
OBJECTIVE: To study the role of xenogenic (pigskin, bovine pericardium) derived acellular matrix patch in pelvic floor repair in animal models. Methods: Thirteen Chinese miniature experimental pigs cultivated by Beijing Agricultural University were selected and divided into three groups. The anterior and posterior wall of vaginal mucosa of miniature pigs were separated from each other in full thickness. Acellular matrix acellular bone substitute (type B bovine pericardium and P type Skin source) and artificial synthetic mesh embedded in the vaginal mucosa of miniature pigs to make animal in vivo models of three materials. At the 2nd, 4th, 8th, 8th and 12th weeks after the operation, the B-type and P-type acellular matrix materials (ATM) Only drawing, drawing ET-VG after staining, dynamic observation patch in animal catabolism, mutual transformation with the surrounding matrix and mucosal reactions around the patch. Results: The gross and histological observations showed that both B and P acellular matrix decellularized patches were degraded in animals with the same general rule (basic metabolism after 12 weeks of transplantation). Compared with the ATM material, the reaction of synthetic mesh is more uniform, and the host tissue better fusion, into the mesh between the mesh, visible around the nascent collagen fibers, fibroblasts, blood vessels and elastic fibers. CONCLUSION: The obvious degradation of xenogenic acellular matrix implants in animal vaginal mucosa implants may be one of the causes of high clinical recurrence rate. Synthetic polypropylene mesh in the body without metabolism, from the biomechanical strength considerations, as pelvic floor repair surgery more advantage of the material. Need to adjust the degradation rate of heterogeneous acellular matrix patch to meet the pelvic floor repair surgery requirements.