兔气管切开后3种缝合材料与吻合口组织中转化生长因子β1的表达:哪种材料更具相容性?  

Expression of transforming growth factor-beta 1 in rabbit anastomotic tissues using three kinds of sutures after tracheotomy: Which one has better histocompatibility?

作　　者：莫靓[1] 游咏[1] 贺大璞[1] 王元星[1] 

机构地区：[1]南华大学附属第一医院心胸外科,湖南省衡阳市421001

出　　处：《中国组织工程研究与临床康复》2009年第47期9245-9248,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：背景：选择合适的吻合材料可提高气管、支气管重建的成功率，减少吻合口瘢痕狭窄。国内目前常用的缝合材料为丝线、涤纶线和人工合成吸收缝线，3种材料中哪种更加有助于预防和减轻术后瘢痕肉芽增生与管腔狭窄尚缺乏相关实验证据。目的：以常用的丝线、涤纶线和人工合成吸收缝线作为缝合材料，创新性开展了3种材料对兔气管切开后吻合口组织病理变化及转化生长因子β1表达影响的观察比较。设计、时间及地点：随机对照动物实验，病理组织学观察，于2005-09/2006-10在南华大学动物实验部完成。材料：人工合成可吸收缝线购自巴西强生专业产品有限公司。缝合丝线、涤纶线分别购自杭州富阳医用缝合针线厂及杭州华威医疗用品有限公司。方法：体质量1.6~2.0 kg健康成年新西兰大白兔36只，雌雄不限，随机抽签法分为丝线组、涤纶线组和人工合成吸收缝线组，每组12只，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。主要观察指标：术后1，2，4周观察吻合口组织病理学变化及转化生长因子β1表达。结果：36只兔全部进入结果分析。术后1，2周3组吻合口愈合状态无明显差别，均有大量炎症细胞浸润，以中性粒细胞为主，集中在缝线周围，并出现灶性出血，缝线形成异物肉芽肿。术后4周，丝线组、涤纶线组均有缝线残留形成异物肉芽肿形成，并有明显纤维组织增生，人工合成吸收缝线组缝合线已基本吸收。与术后1，2周比较，术后4周，丝线组、涤纶线组转化生长因子β1表达降低，但差异无显著性意义；人工合成吸收缝线组降低明显（P 〈 0.05）。结论：3种缝合材料中人工合成吸收缝线组织相容性好，可有效减少手术刺激引起炎症反应的量和程度，更加有助于预防和减轻术后瘢痕肉芽增生和管腔狭窄。BACKGROUND： Appropriate anastomosis materials can improve success rate of trachea and bronchus reconstruction. Common domestic suture materials include silk suture, dacron and synthesized absorbable suture. However, the suture with best effects in preventing and lightening scar granulation hyperplasia and luminal stenosis remains uncertain. OBJECTIVE： To compare the influence of three kinds of suture materials on histopathological changes of anastomotic stoma and transforming growth factor-β1 （TGF-β1） expression in rabbits following tracheotomy. DESIGN, TIME AND SETTING： A randomized, controlled animal experiment and histopathological observation were performed at the Animal Experimental Department, Nanhua University from September 2005 to October 2006. MATERIALS： Artificial absorbable suture was purchased from Brazil Johnson ＆ Johnson Professional Products; silk suture and dacron were purchased from Hangzhou Fuyang Medical Suture Factory and Hangzhou Huawei Medical Products Co., Ltd. METHODS： A total of 36 New Zealand healthy adult rabbits, regardless of gender, weighing 1.6-2.0 kg, were randomly divided into silk, dacron and artificial absorbable suture groups with 12 animals in each group. The end-to-end anastomosis following tracheotomy was performed using silk, dacron and artificial absorbable suture, respectively. MAIN OUTCOME MEASURES： The pathological changes and TGF-β1 level around the sutures 1, 2, 4 weeks post operation were observed. RESULTS： A total of 36 rats were included in final analysis. There were no difference in anastomotic healing between three groups 1 and 2 weeks postoperatively, with a great amount of inflammatory cell infiltration, mainly neutrophil, around the sutures. Moreover, bleeding in the focus and foreign body grannuloma were found. At 4 weeks postoperatively, foreign body grannuloma formed accompanied with obvious firboplasia in silk and dacron groups, and the sutures in the artificial absorbable suture group were absorbed. Compared with 1 and 2 weeks post

关 键 词：气管切开 吻合口 转化生长因子Β1 

分 类 号：R318[医药卫生—生物医学工程]