摘要
目的探讨利用游离腹膜重建黏膜剥脱输尿管的远期疗效及不同剥脱长度的治疗效果。方法成年杂种犬12只,首先制作输尿管黏膜剥脱模型,A组黏膜剥脱长度4am,B组剥脱长度6cm,每组6只。将相应长度的游离腹膜管植入黏膜缺损段,并留置输尿管支架管。术后24周行静脉尿路造影,重建段输尿管组织分别行HE染色及Masson三色染色,观察重建段输尿管组织生长情况。结果造影显示两组各有1只犬手术侧输尿管出现明显狭窄,其余10只犬输尿管均显影良好,无明显狭窄。组织学观察显示两组重建段输尿管黏膜移行上皮生长良好,管腔无明显狭窄,黏膜下可见胶原纤维规则排列,无严重瘢痕形成。结论利用游离腹膜替代可以重建长度达6cm的犬黏膜剥脱输尿管,且远期疗效满意,临床上利用这一方法治疗输尿管黏膜剥脱具有较高的可行性。
Objective To investigate the long-term efficacy of ureteral reconstruction with tubularized peritoneal free grafts for the treatment of avulsion of ureteral mucosa in animal models. Methods The model of avulsion of ureteral mucosa was established in 12 adult dogs. Then they were divided into Group A ( n = 6, length of avulsed mucosa at 4 cm) and Group B ( n = 6, length of avulsed mucosa at 6 cm). And the tubularized peritoneal free grafts and ureteral stents were implanted into the injured ureters. The curative effect was observed by intravenous urethrogram (IVU) and histological examination at Week 24 post-operation. Results Severe stenosis was observed by IVU in l dogs in Groups A and B respectively. In the remaining 10 dogs, IVU showed normal size and morphology of kidneys. There was no hydronephrosis. And no obvious stricture of ureteral part was observed for mucosa substitutes made of peritoneal free grafts. In all 10 dogs without stenosis of both groups, peritoneal membrane was replaced by integrated transitional epithelium. And there was no obvious stricture. Collagen fibers were arranged parallel to mucosal surface. Conclusion For avulsion of ureteral mucosa under 6 cm, reconstruction with tubularized peritoneal free grafts as mucosa substitutes is an effective method. And its long-term efficacy is satisfactory.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第6期412-414,共3页
National Medical Journal of China
基金
上海市卫生局青年科研基金(2006Y75)
关键词
输尿管疾病
腹膜
黏膜
剥脱
Ureteral diseases
Peritoneum
Mucous membrance
Avulsion