不同材料疝补片对大鼠腹壁缺损修补术后行为学影响的实验研究  

Experimental study on the behavioral effects of hernia repair with different material Meshes on rats following abdominal wall defect repair surgery

作　　者：袁雪涛 王星傑 黑赫 田泓漪 刘俊矣 魏光兵 李徐奇 蒋正东 Xuetao Yuan;Xingjie Wang;He Hei;Hongyi Tian;Junyi Liu;Guangbing Wei;Xuqi Li;Zhengdong Jiang(General Surgery Department of the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China;Xi'an Jiaotong University Medical Department,Xi'an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院普通外科,710061 [2]西安交通大学医学部,710061

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第2期154-160,共7页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：国家自然科学基金面上项目(81970456);陕西省重点研发计划(2023-YBSF-208,2022SF-228,2016SF-060)。

摘　　要：目的探讨应用不同材料的疝补片对大鼠腹壁缺损修补术后疼痛及相应的行为学改变的影响。方法36只大鼠分为对照组、腹壁缺损组、聚丙烯补片(PP补片)组与猪小肠黏膜下层脱细胞基质补片(SIS补片)组,应用Von-Frey Test研究大鼠术后疼痛反应,通过高架桥十字迷宫试验研究术后大鼠的焦虑抑郁样行为学改变,使用定量逆转录聚合酶链式反应(qRT-PCR)测大鼠腹壁缺损手术组织的肿瘤坏死因子-α(TNF-α)表达量,苏木精-伊红染色法(HE)观察炎症反应。结果术后第1天、第3天PP补片组与SIS补片组大鼠50%疼痛阈值(50%PT)均显著下降(P<0.05),其中PP补片组大鼠术后出现焦虑抑郁样行为改变(P=0.014),腹壁组织内TNF-α表达量显著上升(P<0.001),炎症反应程度更高;而SIS补片组大鼠50%PT下降幅度比PP补片组低(术后第1天P=0.028,第3天P=0.018),并且没有出现显著行为学改变,其腹壁组织炎症反应程度也较低。结论应用不同材料的疝补片其术后疼痛和局部炎症程度不同,并且能够引起非常显著的行为学改变差异,因此植入不同类型的补片可表现出不同的主观舒适度,SIS补片可能在舒适性上优于PP补片。Objective To investigate the effects of hernia meshes made of different materials on postoperative pain and corresponding behavioral changes in rats.Methods Thirty-six rats were divided into four groups:control,abdominal wall defect,polypropylene mesh(PP mesh),and decellularized submucosa of porcine small intestine mesh(SIS mesh).The postoperative pain response was studied using the Von Frey Test,while the elevated plus maze test was used to investigate postoperative anxiety-and depression-like behavioral changes.Quantitative Reverse Transcription Polymerase Chain Reaction(qRT-PCR)was used to measure the expression levels of tumor necrosis factor-alpha(TNF-α)in the surgical tissue of the abdominal wall defect,and Hematoxylin and Eosin staining(HE)was used to observe inflammatory responses.Results On postoperative days 1 and 3,the 50%pain threshold(50%PT)of both the PP and SIS mesh groups significantly decreased(P<0.05),with the PP mesh group exhibiting anxiety-and depression-like behavioral changes(P=0.014),a significant increase in TNF-αexpression(P<0.001),and a higher degree of inflammatory response.Conversely,the decrease in 50%PT in the SIS mesh group was less than that in the PP mesh group(Day 1 P=0.028,Day 3 P=0.018),with no significant behavioral changes observed,and a lower degree of inflammatory response in the abdominal wall tissue.Conclusion The use of hernia meshes made from different materials results in different levels of postoperative pain and local inflammation,which can lead to significant behavioral changes.Thus,implanting different types of meshes can exhibit different degrees of subjective comfort,with SIS meshes potentially offering superior comfort over PP meshes.

关 键 词：腹外疝 疼痛 焦虑抑郁样行为 疝补片 

分 类 号：R656.2[医药卫生—外科学]