猪脱细胞真皮基质修复兔腹壁缺损的实验研究  

PORCINE ACELLULAR DERMAL MATRIX FOR REPAIR OF ABDOMINAL WALL DEFECTS IN RABBIT MODEL

作　　者：马绍英[1] 王旭昇[1] 董丽[1] 李幼忱[1] 周沫[1] 赵亚平[1] 李宝兴[1] 

机构地区：[1]中国辐射防护研究院生物材料与制药技术研究所,太原030006

出　　处：《中国修复重建外科杂志》2011年第7期884-888,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：山西省自然科学基金资助项目(2008011079-4)~~

摘　　要：目的研究猪脱细胞真皮基质修复兔腹壁缺损的效果,探讨异种脱细胞真皮基质应用的可行性。方法健康小白猪1头,取背部及两侧皮肤制备脱细胞真皮基质。26只日本大耳白兔,雌雄不限,体重2.2～2.3 kg,随机分为对照组(n=6)和实验组(n=20)。对照组制备5.0 cm×0.5 cm腹壁缺损,单纯缝合关闭缺损。实验组制备5.0 cm×2.5 cm腹壁缺损,用同样大小的猪脱细胞真皮基质补片(简称"补片")修复,补片基底膜面朝向肠管。术后观察是否有疝形成,比较两组腹腔内脏器粘连情况,以及对照组腹壁肌筋膜单纯缝合处和实验组补片-腹壁肌筋膜吻合处的最大张力,组织学观察补片是否有纤维血管组织长入及其在体内的生物学转归。结果实验动物均无疝形成。术后5周,实验组补片和腹壁融为一体,补片皮肤面和脏器面均有纤维血管组织长入,补片处于新生组织掺入重建过程。实验组1只动物补片和腹腔内脏器粘连较重(2级),5只发生了轻微粘连(1级),12只无粘连(0级);对照组1只轻微粘连(1级),5只无粘连(0级);两组粘连分级比较差异无统计学意义(Z=—0.798,P=0.425)。术后5周,实验组补片-腹壁肌筋膜吻合处的最大张力为(13.0±5.5)N,对照组腹壁肌筋膜单纯缝合处为(13.6±4.0)N,差异无统计学意义(t=—0.410,P=0.683)。组织学观察显示,术后5周,实验组补片中有大量小血管,并有中性粒细胞及淋巴细胞为主的炎性浸润,补片边缘偶见巨噬细胞,补片-腹壁肌筋膜吻合处由纤维结缔组织连接;术后6个月,补片及周围炎性反应消退,胶原纤维结构发生了改建,补片和肌筋膜层由有纤维结缔组织愈合。结论补片修复兔腹壁缺损取得了较好效果,补片-腹壁肌筋膜层愈合,其吻合处的力学强度达到了自体腹壁单纯缝合吻合的力学强度,补片胶原纤维结构发生了改建。Objective To research the effect of porcine acellular dermal matrix in the reconstruction of abdominal wall defects in rabbits, and to investigate the application feasibility of xeno-transplantation of acellular dermal matrix. Methods The porcine acellular dermal matrix was prepared from a health white pig. Twenty-six Japanese white rabbits （weighing 2.2-2.3 kg, female or male） were randomly assigned to 2 groups： the control group （n=6） and the experimental group （n=20）. In the control group, the fulbthickness abdominal wall defect of 5.0 cm × 0.5 cm was made, and the defect was sutured directly; in the experimental group, the full-thickness abdominal wall defect of 5.0 cm × 2.5 cm was made, and the defect was repaired with porcine acellular dermal matrix patch at the same size as the defect. At 5 weeks after surgery, the incidence of hernia and the intra-abdominal adhesions were observed and the wound breaking strength was compared between the patch- fascia interface and the fascia-fascia interface. The graft vascularization was evaluated through histological analysis at 6 months after surgery in the experimental group. Results No hernia occurred in all rabbits of 2 groups. At 5 weeks after surgery, healing was observed between patch and the muscularfascia; the vascularization was seen in the porcine acellular dermal matrix patch. There was no significant difference in the adhesion grade （Z= -0.798, P=0.425） between the experimental group （grade 2 in 1 rabbit, grade 1 in 5, and grade 0 in 12） and the control group （grade 1 in 1 and grade 0 in 5）. No significant difference was found （t=-0.410, P=0.683） in the breaking strength between the patch-fascia interface in the experimental group [（13.0± 5.5） N] and the fascia-fascia interface in control group [（13.6 ±4.0） N]. In the experimental group, the small vessels and the infiltration of inflammatory cells were observed in the porcine acellular dermal matrix patch after 5 weeks through histological observations. The junction

关 键 词：猪脱细胞真皮基质 腹壁缺损 异种移植重建 兔 

分 类 号：R656.3[医药卫生—外科学]