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作 者:毛静芳[1] 李佳[2] 许蓉蓉[2] 余泽前[2] 杨扬[2] 周家华[2]
机构地区:[1]江苏联合职业技术学院南通卫生分院外科教研室,226007 [2]东南大学附属中大医院普通外科
出 处:《江苏医药》2012年第23期2787-2790,F0002,共5页Jiangsu Medical Journal
基 金:江苏省卫生厅医学基金项目(H200815)
摘 要:目的观察不同质量比聚乳酸-羟基乙酸(PLGA)胆总管支架在体外胆汁中降解情况,实验探索可降解支架修复胆道损伤的可行性。方法用扫描电镜观察不同质量比的PLGA纳米纤维膜微观形貌,并测定其短期体外胆汁中降解率。观察其在胆总管Ⅰ期缝合、胆总管切开置入支架和胆管缺损修补手术中的作用。术后观察动物黄疽和胆漏情况和动物自身术前和术后肝酶(ALT、AST、ALP)和血胆红素的变化。进行Masson染色和平滑肌肌动蛋白(α-SMA)、增殖细胞核抗原(PCNA)免疫组化观察肝脏及胆管损伤部位组织病理学改变。结果 PLGA 75/25和90/10两种比例的纤维在胆汁中没有发生明显的降解和变形。胆管缺损修补手术的猪胶原增生程度轻,排列相对有序,α-SMA免疫组化评分最低,PCNA免疫组化示胆管缺损区域有新生胆管上皮细胞形成。结论可降解静电纺丝PLGA纳米纤维支架能有效支撑和修复胆管缺损。Objective To study the degradation of common bile duct stent composed of different mass ratios of polylactic acid to glycolic acid(PLGA) in bile in vitro,and to assess the feasibility of intraluminal stent repairing bile duct defect.Methods The microstructure of the different mass ratios of PLGA nanofiber membranes was observed with scanning electron microscope,and the degradation rate of nanofiber membranes in bile in a short time was measured.Incidence of jaundice and bile leakage was evaluated and liver enzymes(ALT,AST,ALP) and serum bilirubin were compared before and after repair.Pathomorphologic changes of the anastomoses were observed by HE Masson staining,α-SMA,and PCNA immunohistochemisty.Results There were no obvious distortion and biodegradation of nanofibers in bile seen with the PLGA ratios of 75 to 25 and 90 to 10.The porcine collagen hyperplasia of bile duct after repair was less with the arrangement being relatively in order.Its α-SMA positive expression score was lower and PCNA immunohistochemistry showed neo-bile duct epithelial cells proliferation.Conclusion Electrospun PLGA nanofibers scaffolds can be used to repair bile duct defect and effectively support bile duct.
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