丝素蛋白降低聚丙烯补片表面粘连的研究  

Role of polypropylene mesh coated with silk fibroin hi reducing the abdominal adherence

作　　者：何凯[1] 姚琪远[1] 蒋伏广[3] 王虹[2] 花荣[1] 邵正中[3] 

机构地区：[1]复旦大学附属华山医院普外科,上海200040 [2]复旦大学附属华山医院病理科,上海200040 [3]复旦大学高分子科学系

出　　处：《中华实验外科杂志》2010年第7期889-891,共3页Chinese Journal of Experimental Surgery

基　　金：基金项目：国家高新技术研究发展计划资助项目（2006AA032452）;国家自然科学基金资助项目（30872533）

摘　　要：目的 观察聚丙烯补片经丝素蛋白涂覆后,其表面粘连程度的变化,并探讨其作用机制.方法 将40只Sprague-Dawle大鼠随机分为两组,每组各20只.按组于腹腔内分别植入丝素蛋白涂覆聚丙烯材料（丝素面朝向腹腔,聚丙烯面朝向腹壁）和聚丙烯补片,于术后3、7、14、90 d分批处死大鼠,比较植入补片表面粘连程度及粘连面积,并行病理及扫描电镜检查.结果 丝素蛋白涂覆聚丙烯材料组,术后3、7、14、90d检查基本无腹腔内粘连形成,补片表面粘连面积占总面积的（6.04±4.78）%,粘连程度为（0.8±0.4） 单纯聚丙烯组全部大鼠术后并发腹腔内粘连面积占总面积的（86.61±12.25）%,粘连程度为（3.4±0.6）,有5只（5/20,25.0%）大鼠分别于术后2～9d因肠管与聚丙烯粘连引起肠梗阻或肠瘘死亡,两组的术后腹腔内粘连面积和粘连程度差异均存在统计学意义（P均〈0.05）.结论 丝素材料能促进腹膜间皮细胞长入,于聚丙烯补片表面腹膜化,形成新的间皮细胞层,可有效降低聚丙烯补片与腹腔内器官发生粘连的程度及范围.Objective To explore the merits of polypropylene （ PP） mesh coated with silk fibroin in promoting mesothelial cell hyperplasia, and reducing abdominal adherence. Methods Forty male Spra-gue-Dawle rats were divided randomly as follows： group 1, PP mesh coated with silk fibroin （n = 20） , group 2, pure PP mesh （n=20）. Repair operation was performed on the rats through abdominal cavity with PP mesh coated with silk fibroin （the silk to organ, and the PP to abdominal wall）, or without silk fibroin. All the rats were executed in 3 , 7, 14 and 90 days postoperatively for histopathological and scanning electron microscopic examinations. The quality and quantity of the adherence between mesh and abdominal organs or tissues were measured. Such complications as death, intestinal fistula or obstruction were documented. Results In group 1, there was no obviously adherence on the PP meshes coated with silk fibroin , the area of the adherence on the mesh was calculated as （6. 04 ± 4.78） % and the quality of the adherence as （0. 8 ±0.4） In group 2, 5 rats died in 2, 4, 6, 7, 9 days postoperatively complicated by intestinal fistula or obstruction with serious adherence between the mesh and the intestine. The area of the adherence on the mesh was calculated as （86. 61 ± 12. 25） % and the quality of the adherence as （3.4±0.6）. Conclusion Silk fibroin can promote mesothelial cells agglutination and reform peritoneum on the PP mesh, and effectively decrease the quality and quantity of the adherence postoperatively.

关 键 词：丝素蛋白 聚丙烯补片 腹壁疝 粘连 

分 类 号：R318.08[医药卫生—生物医学工程]