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目的观察光镜、电镜结构变化及转化生长因子(TGF-β)在小儿未闭合鞘状突和腹膜的表达,对小儿斜疝、鞘膜积液发病机制及自愈机制进行初步探讨。方法取手术切除的斜疝疝囊颈部、鞘膜积液囊颈部各30例,正常腹膜10例,进行转化生长因子(TGF-β)的免疫组化分析及光镜、透射电镜下观察组织的结构变化。结果 TGF-β在斜疝、鞘膜积液组和腹膜组均为弥漫中度染色,TGF-β在斜疝、鞘膜积液组和腹膜组之间无统计学意义(P>0.05);光镜下在部分疝囊中可见炎细胞浸润或纤维增生明显伴玻璃样变,鞘膜积液组未见上述改变;电镜下观察标本发现斜疝、鞘膜积液组与腹膜组相比,表面微绒毛消失,间皮细胞脱落,甚至消失,部分病例仅见基底膜或纤维结缔组织。结论 TGF-β在小儿斜疝、鞘膜积液的发生、发展过程中无直接关系。斜疝疝囊、鞘膜积液鞘膜囊的超微结构的改变提示其可能在小儿斜疝、鞘膜积液发生发展过程中发挥作用,可能为将来的非手术治疗方法提供思路。
Objective To observe the changes of light microscopy, electron microscopy and the expression of transforming growth factor (TGF-β) in pediatric unclosed sheath and peritoneum, and to explore the pathogenesis and self-healing mechanism of oblique hernia and hydrocele in children. Methods Thirty cases of surgical resection of hernia sac, 30 cases of hydrocele neck and 10 cases of normal peritoneum were studied. Immunohistochemical analysis of transforming growth factor (TGF-β) and transmission electron microscopy Structural changes in the organization. Results TGF-β was diffusely and moderately stained in the patients with indirect hernia, hydrocele and peritoneum. TGF-β was not significantly different between the group of hernia, hydrocele and peritoneum (P> 0.05). Under the light microscope, inflammatory cell infiltration or fibrogenesis was observed in some of the hernia sacs with obvious vitreous changes, and the above changes were not found in the hydrocele group. Compared with the peritoneal group, Surface microvilli disappear, mesothelial cells shed, or even disappear, in some cases, only the basement membrane or fibrous connective tissue. Conclusion TGF-β in children with indirect hernia, hydrocele occurrence and development process is not directly related. The change of the ultrastructure of the hernia sac and hydrocele of the hernia sac suggests that it may play a role in the development of the hernia and hydrocele in children and may provide some ideas for future non-surgical treatment.