生物可降解输尿管支架在输尿管战创伤治疗中的降解特性  

The degrading progress and character of biodegradable ureteral stent in the treatment of ureter traumatic injury

作　　者：李钢[1] 符伟军[1] 洪宝发[1] 徐福强[1] 曹磊[1] 王忠新[1] 崔福斋[1] 张旭[1] 

机构地区：[1]解放军总医院泌尿外科,北京100853

出　　处：《中华实验外科杂志》2010年第3期333-335,共3页Chinese Journal of Experimental Surgery

基　　金：北京市自然科学基金资助项目（2092029）;全军十一五计划项目面上课题资助项目（06MA298）;解放军总医院科技创新苗圃基金资助项目（08MP-08）

摘　　要：目的建立一种新的输尿管战创伤动物模型，观察生物可降解输尿管支架在输尿管战创伤治疗中的降解特性。方法使用自行研制的火器弹片伤制造模具，对模型建立组9条比格犬的随机一侧输尿管制造火器弹片伤后清创缝合，分别于术后40、80、120d行静脉肾盂造影评估。再对阳性对照组9条比格犬的双侧输尿管均制造火器弹片伤，随机一侧放置聚乳酸可降解输尿管支架，另一侧放置双J管，分别于术后40、80、120d行静脉肾盂造影评估，支架行表面微观形貌及元素分析。结果模型建立组9条比格犬，损伤侧术后出现肾积水，并逐渐加重。阳性对照组的9条比格犬，术后双侧均未见明显肾积水；可降解支架随时间推移逐渐降解，尤其术后80d开始观察到降解速度明显加快；支架表面无钙沉积，而双J管表面可观察到明显钙沉积和结石形成，且随时间进展加重。结论生物可降解支架在治疗输尿管火器弹片伤过程中，在起到了支撑、引流、预防肾积水作用后，随时间推移逐渐降解，并可避免结石形成。Objective To establish a new canine model of ureter trauma and observe the degrading progress and character of biodegradable ureteral stent in the treatment of ureter traumatic injury. Methods A hand-made device was used to make firearm fragment wounds unilaterally on ureters of 9 Beagle dogs in model group. The wounds were debrided and sutured. At the 40th, 80th and 120th day postoperatively intravenous pyelography （IVP） was done. Firearm fragment wounds were made to the bilateral ureters in 9 Beagle dogs of positive control group. A biodegradable stent was placed unilaterally with double-J stent being placed in contralateral ureter. At the 40th, 80th and 120th day postoperatively IVP was done. Then all the animals were sacrificed and stents were removed for surface microcosmic appearance analysis and elemental analysis. Results In model group, the hydronephrosis and hydroureter occurred and got worse postoperatively on the wounded side in all 9 Beagle dogs. In positive control group no significant hydronephrosis or hydroureter was found postoperatively on both sides. Biodegradable stents were degraded as time went on. The degradation rate became faster at the 80th day postoperatively. No calcium sedimentation was found on the biodegradable stent surface, while on the double-J stent significant calcium sedimentation was found and thickened as time went on. Conclusion The new canine model of firearm fragment wounds was viable and effective. In positive control group, both the biodegradable stent and double-J stent were effective for support and drainage, protecting against stenosis in ureter and hydronephrosis. And the biodegradable stent is degraded automatically and prevents the formation of calculus on the surface.

关 键 词：聚乳酸 输尿管 支架 火器伤 

分 类 号：R318.08[医药卫生—生物医学工程]