生物可降解雷帕霉素输尿管支架修复输尿管战创伤的研究  

Biodegradable rapamycin-eluting ureteral stent for ureter traumatic injury

作　　者：王忠新[1] 谭海颂[1] 符伟军[1] 许永德[2] 李钢[3] 王晓雄[2] 刘振湘[4] 白志明[4] 

机构地区：[1] 解放军总医院海南分院泌尿外科, 三亚572014 [2] 解放军总医院泌尿外科 [3] 解放军第三○九医院全军器官移植研究所 [4] 海口市人民医院中南大学湘雅医学院附属海口医院

出　　处：《中华实验外科杂志》2014年第9期1977-1979,F0003,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（81070555）;北京市自然科学基金资助项目（2092029）;军队临床高新技术重点项目（413DG63J）

摘　　要：目的 探讨生物可降解雷帕霉素输尿管支架修复战创伤性输尿管损伤的可行性和有效性.方法 自行设计定位爆炸装置,构建战创伤输尿管损伤动物模型.生物可降解雷帕霉素输尿管支架和双J管分别置入损伤段输尿管,6周时模拟临床实际取出双J管,通过静脉肾盂造影（IVP）、肾图及组织学方法评估生物可降解雷帕霉素输尿管支架修复输尿管战创伤的可行性和有效性.结果 术后18周,影像学检查生物可降解雷帕霉素输尿管侧未见明显输尿管支架影,提示支架已降解排出,输尿管引流通畅;而双J管侧输尿管及肾盂出现中、重度积水;肾图提示双J管侧肾小球滤过率由术前（32.10±3.56） ml/min下降至（15.00±3.35） ml/min,半排时间由术前（4.80±0.75）s延长至（13.10±1.26）s;而生物可降解雷帕霉素输尿管支架侧,各时间点肾功能差异无统计学意义（P＞0.05）.组织学检查证实雷帕霉素输尿管支架侧组织反应轻,生物相容性好.结论 生物可降解雷帕霉素输尿管支架可有效地修复输尿管损伤,具有更好的生物相容性.Objective To evaluate the feasibility and effectiveness of the biodegradable rapamycin-eluting stent in the treatment of ureteral traumatic injury.Methods The anima traumatic ureteral injury model was made by a self-designed explosion device.Both biodegradable rapamycin-eluting ureteral stent and double-J stent were surgically implanted into the ureters.By intravenous pyelography （IVP）,radioactive renography and histological findings at different time points,the feasibility and effectiveness of the biodegradable rapamycin-eluting ureteral stent in the treatment of ureteral injury were evaluated.Results After 18 weeks,no obvious signs of biodegradable rapamycin-eluting stent were found,which indicated that the stent was degraded.IVP demonstrated that the ureters on the biodegradable rapamycin-eluting stent side were smooth and clear,while moderate to severe hydronephrosis appeared on the double-J stent side.Renography examinations showed on the double-J stent side,the glomerular filtration rate was decreased from （32.10 ±3.56） ml/min to （15.00 ±3.35） ml/min,and C1/2 time extended from （4.80 ±0.75） s to （13.10 ± 1.26） s,while on the biodegradable rapamycin-eluting stent side,the renal function showed no significant difference at each time point.Histological results indicated the tissue reactions were milder on the biodegradable rapamycin-eluting stent side than on the double-J stent side,and no signs of scar formation were found.Conclusion The biodegradable rapamycin-eluting stent showed favorable therapeutic prospects in the treatment of ureteral traumatic injury with good biocompatibility as compared with double-J stent.

关 键 词：输尿管损伤 雷帕霉素支架 生物可降解 

分 类 号：R318.08[医药卫生—生物医学工程]