孕晚期宫内修补胎羊腹壁缺损的初步实验研究  

PRELIMINARY EXPERIMENTAL STUDY ON INTRAUTERINE ABDOMINAL WALL DEFECT REPAIR OF FETAL LAMB AT LATE PREGNANCY

作　　者：孙俊杰[1] 汪凤华 邓高燕 汪帕[1] 莫家骢[1] 

机构地区：[1]中山大学附属第一医院小儿外科,广州510080 [2]广州市妇女儿童医疗中心小儿外科

出　　处：《中国修复重建外科杂志》2011年第6期689-692,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：广东省科学技术厅科技项目(2007B030502008;2008B060600030)~~

摘　　要：目的探讨孕晚期行宫内手术修补胎羊腹壁缺损的可行性。方法取8只孕110～115 d的健康山羊,体重14～22 kg,随机分为两组,分别为可吸收缝线组(A组,3只)及生物型补片组(B组,5只)。两组首先切除胎羊全层腹壁分别制备大小约5 cm×1 cm及5 cm×2 cm的腹壁缺损模型后,分别采用可吸收缝线缝合及两层生物型补片修补腹壁缺损。观察术后母羊及出生后小羊一般情况;于出生后第10天处死小羊观察腹腔内粘连情况,并取切口瘢痕组织行生物力学测定和组织学观察。结果术后共3只母羊流产,其中A组1只,B组2只;其余母羊均顺利娩出小羊。A组小羊腹壁切口愈合好,瘢痕呈线形,腹腔内粘连轻;瘢痕厚度为4～5 mm。B组小羊腹壁切口均未完全愈合,腹腔内粘连轻;瘢痕厚度为3～4 mm。生物力学测定A组瘢痕组织皮条断裂力为16、20 N,B组为10、14、18 N。组织学观察示,A组瘢痕组织范围小;B组见皮肤溃疡面和其下的纤维结缔组织,伴炎性细胞浸润。结论 孕晚期行宫内手术修补胎羊腹壁缺损可行;对于腹壁缺损较小者可直接缝合修补,缺损较大者可采用生物型补片修补。Objective To evaluate the feasibility of intrauterine abdominal wall defect repair of fetal lamb at late pregnancy.Methods Eight healthy pregnant ewes at 110-115 days of gestation（weighing 14-22 kg） were randomly divided into 2 groups.In group A（n=3）,the abdominal wall defect of 5 cm × 1 cm was made in the fetal lambs,then was closed by strengthening suture;in group B（n=5）,the abdominal wall defect of 5 cm × 2 cm was made in the fetal lambs,then was repaired by 2 layers of biological patches.After the lambs delivered naturally,the lambs and their wounds were observed;at 10th day after birth,the scars were harvested for biomechanical and histological observations.Results One ewe of group A and 2 ewes of group B aborted,while the others were successfully delivered.In group A,the abdominal incisions of 2 lambs healed well with a line-like scar and mild intra-abdominal adhesion,and the scar thickness was 4-5 mm.In group B,the abdominal incisions of 3 lambs did not heal completely with minor intra-abdominal adhesions,and the scar thickness was 3-4 mm.The wound breaking strength was 16,20 N in group A and 10,14,and 18 N in group B,respectively.A slight scar was seen in group A;skin ulcer and underlying fibrous connective tissue with inflammatory cell infiltration were seen in group B.Conclusion It was feasible to repair the abdominal wall defect of fetal lamb at late pregnancy in uterine.Small abdominal wall defect can be sutured directly;biological patch can be used to repair larger abdominal wall defect.

关 键 词：先天性腹壁缺损 宫内修补 生物型补片 山羊 

分 类 号：R719[医药卫生—妇产科学]