三种缝合材料对兔气管吻合口愈合质量的影响  

Influence of three suture materials on the healing quality of rabbit wounds in tracheal anastomosis

作　　者：贺大璞[1] 莫靓[1] 游咏[1] 王元星[1] 

机构地区：[1]南华大学第一附属医院心胸外科,湖南省衡阳市421001

出　　处：《中国组织工程研究与临床康复》2007年第40期8034-8037,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：湖南省卫生厅科研基金课题资助项目(C2005037)~~

摘　　要：目的:采用动物实验观察临床常用的3种缝合材料对气管端端吻合术后组织反应、愈合质量的影响。方法:实验于2005-09/2006-10在南华大学动物实验部将36只新西兰大白兔随机分为3组,分别选用丝线、涤纶线、人工合成吸收缝线进行气管切开后端端吻合。于术后1,2,4周分别取吻合口处气管,计算出吻合口内径占术前气管内径的百分率,反映气管的通畅程度;组织切片病理学观察炎症细胞浸润程度;免疫组织化学SABC法测定转化生长因子β1阳性面积比。结果:①肉眼观察显示:术后1,2周3组吻合口愈合没有显著差别,术后4周丝线组、涤纶线组均有缝线残留形成肉芽肿,人工合成吸收缝线组缝线基本吸收。②吻合口内径通畅率:术后1周、2周3组无显著差别(P>0.05),术后4周人工合成吸收缝线组高于其他2组(P<0.05)。③炎症细胞浸润程度:术后1,2周3组间比较无显著差别(P>0.05);术后4周人工合成吸收缝线组低于其他2组(P<0.05)。④转化生长因子β1阳性面积比:术后1,2周3组间比较无显著差别(P>0.05);术后4周人工合成吸收缝线组低于其他2组(P<0.05)。结论:兔气管切开后行端端吻合术,采用人工合成吸收缝线组织相容性好,炎症反应低,有利于吻合口的愈合。AIM： To demonstrate the effects of three suture materials on the tissue reaction and wound healing quantity after clinical tracheal anastomosis in animal experiments. METHODS： The experiment was carried out in the Animal Experimental Center of Nanhua University from September 2005 to October 2006. A total of 36 New Zealand rabbits were randomly divided into silk group, dacron group and artificial absorbable suture group for the end-to-end anastomosis. The rabbits trachea in anastomotic site were sampled 1, 2, 4 weeks after operation. The percentage of anastomotic diameter to preoperative tracheal diameter was measured to reflect the tracheal stenosis; pathological examination of tissue sections was done to observe the infiltration of inflammatory cells; the positive area ratio of transforming growth factor （TGF） 131 was determined using immunohistochemistry. RESULTS： ①Macroscopic observation： There were no significant differences on the wound healing among three groups 1 week and 2 weeks postoperatively; the artificial absorbable suture were absorbed 4 weeks later, but granuloma formed in the other two groups. ②Anastomotic patency rate： There were no differences among three groups 1 week and 2 weeks postoperatively （P 〉 0.05）; Four weeks later, the change rate of anastomotic diameter in the artificial absorbable suture group was higher than that in the other two groups （P 〈 0.05）.③lnfiltration of inflammatory cells： There were no difference among three groups 1 week and 2 weeks postoperatively （P 〉 0.05）; Four weeks later, the infiltrating degree of the inflammatory cells in the artificial absorbable suture group was lower than that in silk group and dacron group （P 〈 0.05）.④TGF-131 levels were no different 1 week and 2 weeks postoperatively among three groups （P 〉 0.05）, but after 4 weeks, the expression of TGF-131 was decreased significantly in absorbable suture group （P 〈 0.05）. CONCLUSION： The artificial absorbable suture affords excellent characte

关 键 词：气管吻合 缝合材料 转化生长因子Β1 

分 类 号：R318.08[医药卫生—生物医学工程]