SIS修复重建兔气管缺损的实验研究  

AN EXPERIMENTAL STUDY ON SIS IN RECONSTRUCTION OF TRACHEAL DEFECT IN RABBITS

作　　者：黄光平[1,2] 项舟[1,2] 杨志明[1] 梁新刚[1,2] 李秀群[1] 解慧琪[1] 邓力[1] 

机构地区：[1]四川大学华西医院生物治疗国家重点实验室干细胞与组织工程研究室,成都610041 [2]四川大学华西医院骨科

出　　处：《中国修复重建外科杂志》2009年第3期328-331,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(30271317)~~

摘　　要：目的探讨SIS覆盖的聚丙烯补片(polypropylene mesh,PPM)修复重建兔气管缺损的可行性,及SIS在促进气管纤毛柱状上皮再生、减少术后并发症等方面的作用。方法取12只新西兰大白兔,体重1.8～2.0kg,制备大小为1.2cm×0.6cm的气管前壁、侧壁4～6环全层缺损模型。根据修复材料不同,随机分为两组,每组6只。PPM修复组采用大小为1.4cm×0.8cm的单纯PPM修复缺损;SIS-PPM修复组采用预先紧密缝合的大小为1.4cm×0.8cm的SIS和PPM修复缺损。术后观察动物一般情况,于4、8、12周取材进行大体观察、HE染色及扫描电镜观察重建区域情况。结果术后SIS-PPM修复组动物均存活至实验完成,无感染、皮下气肿、呼吸困难发生。PPM修复组分别于术后6d及18d因气道感染及气道分泌物潴留死亡1只兔,其余动物均出现不同程度的颈部皮下气肿。两组动物重建气管均无塌陷、狭窄。组织学观察:术后各时间点两组动物气管腔内均未见明显肉芽及瘢痕,8、12周时重建气管表面有气管黏膜覆盖,SIS-PPM修复组纤毛组织和杯状细胞多于PPM修复组。扫描电镜观察:术后8周SIS-PPM修复组重建气管中心区域大部分被较成熟的纤毛覆盖,PPM修复组重建中心区域大部分为幼稚纤毛覆盖;12周时SIS-PPM修复组纤毛方向性好,纤毛无明显分泌物附着;PPM修复组纤毛凌乱,纤毛表面有大量分泌物附着。结论SIS和PPM修复重建气管缺损能充分维持修复重建后的气道形态和生理功能,并能获得良好的上皮化。SIS具有促进气管黏膜修复愈合,减少术后皮下气肿、气管狭窄的作用,有望用于临床修复重建气管组织缺损。Objective To investigate the feasibility of polypropylene mesh （PPM） coated with SIS to reconstruct tracheal defect and theffe ciency of SIS in improving epithelialization of the reconstructed trachea and reducing the post-operative complications. Methods Twelve New Zealand white rabbits were chosen and divided randomly into 2 groups： PPM reconstruction group （n=6） and SIS-PPM reconstruction group （n=6）. A tracheal full defect with a size of 1.2 cm×0.6 cm was created. A PPM coated with SIS of 1.4 cm×0.8 cm was inserted to the defect in SIS-PPM reconstruction group,pure PPM of 1.4 cm×0.8 cm in PPM reconstruction group. Complications such as death,local in ammation,tracheal stenosis and subcutaneous emphysema were documented. After 4,8 and 12 weeks,tracheal histological examination and SEM examination were performed. Results In SIS-PPM reconstruction group,all animals survived at theffend of theffexperiment,no infection,subcutaneous emphysema and breathing di culties occurred. In PPM reconstruction group,there was 2 deaths because of infection of lumina and su ocation after 6 and 18 days of implantation; all rabbits had local subcutaneous emphysema. The histological examination showed that there was no obvious granulation tissue and scar in two groups and that the mucous membrane and cilia grew more normally in SIS-PPM reconstruction group than in PPM reconstruction group. SEM observation： At 8 weeks after implantation,most of the reconstructed area of the trachea in SIS-PPM reconstruction group was covered by relatively mature cilia; the corresponding area in PPM reconstruction group was covered by the naive cilia. At 12 weeks after implantation,the cilia in SIS-PPM reconstruction group grew orderly without obvious secretion adherence; while the cilia in PPM reconstruction group grew in a disorderly manner and were attached by an abundance of secretion. Conclusion Good epithelial regeneration can be achieved after repair of tracheal defect using PPM coated with SIS. SIS can promote regeneration

关 键 词：SIS 聚丙烯补片 气管缺损 气管上皮化 修复重建 兔 

分 类 号：R653[医药卫生—外科学]