硅凝胶所致纤维包膜移植后的组织观察

Fibrous capsule caused by silicone gel:a histological observation after transplantation

目的研究硅凝胶所致纤维包膜移植后的组织变化。方法取16只白色封闭群SD大鼠,分别于四肢皮下埋置硅凝胶片,1个月后取出硅凝胶片并将形成的纤维包膜移植至他处或留于原位,于纤维包膜移植后3 d (A组)、1周(B组)、1个月(C组)、3个月(D组)观察其组织结构及纤维构成。结果移植部位均有轻度红肿,术后1周左右红肿消退,所有伤口均平整愈合好,局部组织柔软,移植的纤维包膜没有掉落发生。A组左、右两侧(即未移植包膜和移植后包膜)纤维包膜厚度及回缩率的差异无统计学意义(P值均>0.05),而B、C、D组左、右两侧的差异均有统计学意义(P值均<0.05)。A组右侧纤维包膜厚度及回缩率与其余3组的差异均有统计学意义(P值均<0.05),而B组与C组及C组与D组之间的差异均无统计学意义(P值均>0.05)。A组右侧纤维包膜强度、阳性面积率及吸收率与其他3组的差异均有统计学意义(P值均<0.05),B、C、D组之间的差异均无统计学意义(P值均>0.05)。A组左、右两侧纤维包膜强度、阳性面积率及吸收率的差异均无统计学意义(P值均>0.05),B、C、D组左、右两侧的差异均有统计学意义(P值均<0.05)。结论硅凝胶作为异物刺激周围组织形成的纤维包膜在假体取出后会逐渐吸收,可能并不需要同时去除,并且这个纤维包膜可能成为一个有前途的自体移植物。

Objective To investigate the histological changes of fibrous capsule caused by silicone gel after transplantation. Methods Silicone gels were implanted subcutaneously in four legs in 16 SD rats. One month later the silicone gel was removed and the fibrous capsule was left at the original sites or transplanted to other sites the histological changes and fibrous structure were observed at 3 days, 1 weeks, 1 months and 3 months later. Results Slight redness and edema were noticed at all transplanted sites and disappeared about one week later. The incisions healed well and the local tissues were soft; no removal of the transplanted capsules was noticed. The thickness and absorbance rate of the transplanted and untransplanted capsules were similar in Group A （both P 〉 0.05 ）, but they were significantly different in those of Group B, C, and D （all P 〈 0.05）. The thickness and absorbance rate of transplanted capsules in Group A were significantly different from those of the other 3 groups （all P 〈 0.05） ; there was no significant difference between those of Group B and C, Group C and D （all P 〉0.05）. The intensity, positive area rate, and absorbance rate of the transplanted capsules in Group A were significantly different from those of the other 3 groups （all P 〈 0.05 ） ; there was no significant difference between Group B, C and D （all P 〉 0.05） and between the transplanted and untransplanted capsules in Group A（ all P 〉0.05） ; and there was significant difference between the transplanted and untransplanted capsules in Group B, C, and D （ all P 〈 0.05 ）. Conclusion Silicone gel as the foreign body can induce the formation of the fibrous capsules, which can be gradually absorbed after the removal of the foreign body. The silicone gel-induced fibrous capsule might be a promising autograft in the future.