可降解和不可降解输尿管支架在家犬输尿管中的病理学变化

Pathologic changes of canine ureter caused by degradable and undegradable stent

背景:目前临床应用的输尿管支架主要由不能在人体内降解的硅酮、聚氨甲酸乙酯等为原料制成,置入体内一段时间后必须通过有创的侵入性操作拔除,增加了患者的痛苦。目的:比较可降解材料消旋聚乳酸输尿管支架和聚氨甲酸乙酯支架在家犬输尿管内的组织病理学变化。方法:经开放手术分别将消旋聚乳酸支架和聚氨甲酸乙酯支架置于19只家犬左右两侧输尿管内,术后每2周取出支架4次,同时切取输尿管组织在光镜下观察输尿管组织病理改变。结果与结论:术后第2周和第4周两侧输尿管有明显的上皮脱落、固有层水肿和肌层结构紊乱,第6周仅发现固有层小血管充血,第8周输尿管全层组织基本恢复正常。结果证实消旋聚乳酸输尿管支架具有良好的组织相容性。

BACKGROUND：The presently used ureteral stent are made of undegradable silicone and polyurethane,which must be removed by operation after a certain period of implantation.OBJECTIVE：To observe the pathologic changes of canine ureter caused by poly-DL-lactic acid stent and polyurethane stent.METHODS：Poly-DL-lactic acid and polyurethane stents were implanted in different sides of canine ureters by operation.Ureteral incision specimens were obtained every two weeks.The pathologic changes of canine ureter were observed under light microscope.RESULTS AND CONCLUSION：Traumatic inflammation was the main pathological change of all ureteral specimens.Epithelial decortication,edema of the proper layer and disarrangement of the muscle layer were obvious at the second and the fourth weeks.The arteriolar congestion in proper layer was found at the sixth week.There was no significant disorder at the end of eighth week.The result demonstrated that Poly-DL-lactic acid stent has fairly good tissue compatibility.