子鼠脊髓脊膜膨出胎内修补研究  

Preliminary experimental study on fetal myelomeningocele repair

作　　者：汤梁峰[1] 钟海军[1] 沈剑[1] 陈宏[1] 毕允力[1] 

机构地区：[1]复旦大学附属儿科医院泌尿外科,上海201102

出　　处：《中华实验外科杂志》2014年第7期1443-1444,共2页Chinese Journal of Experimental Surgery

基　　金：国家临床重点专科建设项目

摘　　要：目的 利用维甲酸灌胃孕鼠诱导的大鼠子鼠脊髓脊膜膨出动物模型,建立一种动物实验方法,观察壳聚糖明胶薄膜在修补子鼠脊髓脊膜膨出的效果。方法 利用维甲酸灌胃孕SD大鼠获得脊髓脊膜膨出的子鼠动物模型,在孕中期（孕18 d）利用经腹经子宫开放手术,以壳聚糖明胶薄膜作为组织工程材料修补脊髓脊膜膨出皮肤缺损。在孕21 d取胎,观察手术成功率,并以未经手术修补的子鼠为对照,观察组织病理学改变。结果 通过建立动物模型,用44只可利用的子鼠顺利进行了28例修补,修补后存活13只,其中获得了10只修补满意的子鼠。观察到了修补手术后局部的组织改变。以未经修补的子鼠为对照,通过测定免疫组织化学染色切片中的吸光度值,发现神经微管蛋白-β-Ⅲ在子鼠膀胱表达显著高于对照组,且和普通子鼠比较差异无统计学意义（P〈0.05）。结论 壳聚糖-明胶薄膜作为组织工程材料可应用在该手术模型中,对脊髓脊膜膨出子鼠膀胱神经发育有改善作用。Objective To establish an animal experimental method for investigating the effect of fetal myelomeningocele （MMC） repair with chitosan gelatin membrane, and then observe the bladder protective effect of fetal surgery. Methods Fetal myelomeningocele rats were obtained by feeding pregnant rats with retinoic acid. Open abdominal fetal surgery was performed, and repair of MMC using chitosan gelatin membrane as tissue engineering materials. Fetal rats after repair were harvested bofore dilivery. By observing the success rate of surgery and pathological changes, data were analyzed compare to MMC fetus in groups. Results 44 fetuses underwent repairment, and the use of chitosan gelatin membrane patch in fetal surgery was successful in 10 fetuses. Local tissue changes after the repair of MMC. According to the optical density value in immunochemistry staining, the expression of nerve tubulin-β-Ⅲ in the fetal bladder was significantly higher in operation group as compare with MMC control group, and it bad no difference to normal control. Conclusion Our preliminary study confirmed that cbitosan gelatin membrane as tissue en- gineering materials in the MMC fetal surgery is feasible, and it showed the protection effect to fetal spine and bladder.

关 键 词：脊髓脊膜膨出 胎内修补 

分 类 号：R726.1[医药卫生—儿科]