人羊膜细胞外基质修复尿道下裂的实验研究  

Experimental Study on Hypospadias Repair with Human Amnion Extracellular Matrix

作　　者：舒林飞 田源[2] 王雷 肖跃海[2] 孙超[2] 唐开发[2] 孙发[2] SHU Linfei TIAN Yuan WANG Lei XIAO Yuehai SUN Chao TANG Kaifa SUN Fa(Graduate,School, Guizhou Medical University, Guiyang 550004, Guizhou, China The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou , China Department of Urinary Surgery, Hebei Provincial Qinhuangdao Central Hospital, Qinhuangdao 066000, Hebei , China)

机构地区：[1]贵州医科大学,贵州贵阳550004 [2]贵州医科大学附院,贵州贵阳550004 [3]河北省秦皇岛中心医院泌尿外科,河北秦皇岛066000

出　　处：《贵州医科大学学报》2017年第3期263-268,共6页Journal of Guizhou Medical University

基　　金：国家自然科学基金项目(81360097);贵州省科技厅项目[黔科合LH字(2014)7126];贵州省卫计委科技基金项目(gzwjkj2014-1-035);贵州省卫计委科技基金项目(gzwjkj2015-1-036);贵阳市科技基金[(2010)筑科农合同第1-社-25号]

摘　　要：目的:研究人羊膜细胞外基质(HAECM)修复新西兰兔阴茎型尿道下裂的效果。方法:选择新鲜健康剖宫产胎盘分离出羊膜,制备HAECM;将36只雄性新西兰白兔切除1 cm前尿道黏膜,建立尿道下裂动物模型,并随机分为对照组、HAECM单层修复组及多层修复组,每组12只;对照组采用传统的加盖岛状皮瓣(Onlay式)对兔尿道下裂进行手术修复,HAECM单层和多层修复组分别采用单层和多层HAECM作为修复材料对兔尿道下裂进行手术修复,于术后第20和40天时行尿道造影和尿道镜检查,并于术后第10、20和40天时对术后尿道标本进行病理学观察,了解术后尿道情况。结果:成功制备出优质的HAECM;尿道病理组织学检查结果示:术后第10天时,实验组尿道管腔面有少量尿道上皮细胞生长;术后第20天时,实验组可见尿道管腔被覆上皮已基本覆盖HAECM修复区;术后第40天时,单层修复组、多层修复组脱细胞羊膜修复处尿道管腔被覆尿路上皮细胞完整,黏膜下层可见平滑肌生长,纤维组织、小血管增生,少量炎细胞浸润;对照组可见尿道管腔完整,平滑肌层连续性完好,可见少量炎细胞;尿道造影检查示术后第40天时,单层、复层修复组和对照组尿道通畅,未见狭窄、造影剂外渗、憩室形成;尿道镜检查示术后第40天时,单层、多层修复组和对照组尿道通畅,未见明显狭窄。结论:单层和复层HAECM对兔尿道下裂修复效果良好,HAECM是一种前景良好的修复材料。Objective：To study the curative results of penis hypospadias repair in New Ziland rabbits with human amnion extracellular matrix（ HAECM）. Methods：HAECM was prepared with fresh health placenta from cesarean and freeze-dried after ethylene oxide sterilization. Hypospadias animal models were made with 36 male New Zealand white rabbits by excision of 1 cm of anterior urethral mucous membrane. The models were randomly divided into 3 groups（ 12 in each） ：control group（ group C）,HAECM single layer repair group（ group HS）,and HAECM multilayer repair group（ group HM）. Traditional Onlay hypospadias repair method was adopted to group C,and single layer and multilayer of HAECM as repair material were used in surgery of groups HS and HM respectively. Urethrography and urethroscopy observation were made on the 20 thand 40thdays after the surgery. Pathological observation was made with urethral sections on the 10 ^th,20^th,and 40 thdays after the surgery. Results：HAECM with good quality was Prepared successfully. Pathological observation showed that,in 10 days after repair surgery,in groups HS and HM,a few urethral epithelial cells were found on urethral lumen surface; On the 20^th day postoperation,in groups HS and HM,the HAECM repair area was basically covered by urethral lumen lining epithelium; in 40 days after the operation,in acellular amniotic membrane repairing area of groups HS and HM,the urothelial cells coated urethral lumen completely,and growth of smooth muscle,proliferation of fibrous tissue and vascular,and infiltration of inflammatory cells were seen in the submucosa,while in control group,a complete urethral lumen,continuous smooth muscle layer,and a small amount of inflammatory cells were found. On the 40 ^thday after operation,the urethrography examination results showed that,in both experimental groups and control group,urethral tract was unobstructed,no stenosis,no contrast agent extravasation,nor diverticulosis was seen,while the urethroscopy results proved urethral tract was un

关 键 词：尿道下裂 修复外科手术 组织工程 人羊膜细胞外基质 新西兰兔 

分 类 号：R695[医药卫生—泌尿科学] R628[医药卫生—外科学]