冻干无细胞膀胱黏膜下基质修复兔尿道缺损  

Rabbit urethral defect repair with freeze-dried acellular bladder submucosa

作　　者：王永前 李养群 刘立强 徐家杰 霍然[2] 李强[1] 李森恺 

机构地区：[1]中国医学科学院整形外科医院尿道下裂中心,北京100041 [2]山东省立医院烧伤整形外科

出　　处：《中华整形外科杂志》2005年第1期62-65,共4页Chinese Journal of Plastic Surgery

基　　金：卫生部临床学科重点项目基金 (2 0 0 10 40 9);国家自然科学基金 (3 0 0 70 779);高等学校博士点基金 (2 0 0 10 0 2 3 0 0 2 )资助

摘　　要：目的　探讨冻干无细胞膀胱黏膜下基质修复尿道缺损的效果。方法　应用反复冻融-酶法及冷冻干燥技术制备冻干无细胞人体膀胱黏膜下基质。 18只新西兰白兔建立尿道中段部分缺损模型 ,尿道缺损面积约 1 0cm× 0 5cm。其中 14只兔作为实验组 ,以冻干无细胞膀胱黏膜下基质修补尿道缺损 ,术后 1、2、3、4、8、12、2 4周分别取 2只行逆行性尿道造影 ,观察尿道情况 ,并采取尿道组织进行大体、组织学及超微结构观察 ;4只兔作为对照组 ,未采用任何材料修补尿道缺损 ,直接缝合尿道海绵体包膜、皮下组织及阴茎皮肤 ,术后 2、4周分别取 2只行逆行性尿道造影 ,采取尿道组织进行大体观察。结果　实验组 14只兔均未发现明显的尿道狭窄。冻干无细胞膀胱黏膜下基质组织相容性良好 ,移植后无细胞膀胱黏膜下基质内有细胞长入 ,新生血管形成 ,术后 2周无细胞膀胱黏膜下基质移植区完全上皮化。随着移植时间的延长 ,移植区胶原纤维排列由紊乱趋于规则。结论　冻干无细胞膀胱黏膜下基质能够诱导尿道黏膜细胞迁徙、生长和上皮化 ,初步认为可以作为尿道缺损修复材料。Objective To evaluate the result of urethral defect repair using freeze dried acellular bladder submucosa. Methods The freeze dried acellular bladder submucosa was obtained from human cadaveric bladder submucosa using freeze thawed enzymatic treatment and the freeze drying technique. 18 male New Zealand rabbits were used in this experiment. A defect of 1 0 cm×0 5 cm was created in the ventral urethra of the animal. The acellular matrix was grafted to the urethral defect in 14 rabbits. The other 4 animals underwent a sham operation as the controls. From postoperative one to twenty four weeks, the animals underwent retrograde urethrography at certain intervals. The grafts of the acellular matrix were taken and prepared for histological evaluation. Results No obvious urethral stricture was observed in the 14 matrix grafted animals. Histological examinations of the specimens showed progressive infiltration of cells and vascular vessels. Complete epithelization was obtained at 2 weeks. The orientation of collagen fibers in the matrix grafted area tended to be regular with time. Conclusions Freeze dried acellular bladder submucosa may be a suitable material for urethral defect repair, which induces urethral mucous cells to migrate, grow and epithelialize. ;

关 键 词：无细胞基质 尿道缺损 冻干无细胞膀胱黏膜 阴茎皮肤 皮下组织 尿道海绵体包膜 

分 类 号：R699[医药卫生—泌尿科学]