论文部分内容阅读
目的探讨撕脱输尿管去外膜后自体移植于带肠系膜缘浆肌层肠段以重建输尿管血运的可行性。方法将33只杂交犬分A组3只、B组15只、C组15只,B、C组术后又分4周组、6周组、8周组,每组各5只。所有犬均分离出带肠系膜缘的浆肌层肠段作为移植床模型,A组、B组、C组分别采用输尿管切开置管、保留输尿管外膜和去除输尿管外膜3种方法制备输尿管模型,将各组制备的输尿管模型分别移植到浆肌层肠段内,于术后4、6、8周分别处死相应组别的犬,取出移植输尿管进行病理检查。结果 A组输尿管黏膜及肌层保持正常状态;B组移植输尿管内膜层移行上皮细胞消失,输尿管壁肌层退化、变薄或消失,外膜层可见黄色钙化斑以及大量炎性细胞侵润;C组移植输尿管内膜有移行细胞存在,细胞核生长良好,细胞层(2~3层)较正常减少,输尿管壁肌层存在,并与外周肠壁肌层融合,血运重建良好。结论撕脱输尿管去外膜后自体移植于带肠系膜缘浆肌肠段能够使输尿管的血运快速建立,这可能是将来解决输尿管撕脱造成输尿管长段缺损的有效方法之一。
Objective To explore the feasibility of transplanting the ureter to the adventitia and transplanting it into the intestine of mesentery marginal muscularis mucosa to reconstruct the ureteral blood flow. Methods A total of 33 dogs were divided into group A, group B, group C, group C, group B, group C and group C respectively. All dogs were separated with intestinal mesentery margin of the intestinal muscle segment as a transplant bed model, A group, B group, C group were ureter incision catheter, retaining the ureteral adventitia and remove the outer membrane of the ureter three kinds of methods to prepare the ureter model The ureter models prepared in each group were respectively transplanted into the intestine of the muscular layer, and the corresponding groups of dogs were sacrificed 4, 6 and 8 weeks after the operation respectively. The ureter was removed for pathological examination. Results The ureteral mucosa and muscular layer of group A remained normal. In group B, the transitional epithelial cells disappeared and the ureteral wall muscle layer degenerated, thinned or disappeared. The yellow calcified plaque and a large number of inflammatory cells infiltrated in the adventitial layer. In group C, transplanted ureter had transitional cells in the intima, and the nuclei grew well. The cell layers (2-3 layers) were reduced compared with the normal ones. The ureteral wall muscularis existed, and was fused with the peripheral wall muscle layer. The revascularization was good. Conclusions The avulsion of the ureter to the adventitia after autotransplantation in the intestine with mesenteric margin of the serosal muscle can make rapid ureteral blood flow, which may be the future to solve the ureteral avulsion caused by long-term ureteral defect in one of the effective ways.