脱细胞小肠黏膜下层与脱细胞心包修复大鼠腹壁缺损的对比研究

Comparative Study of Acellular Small Intestinal Submucosa and Acellular Pericardium for Repairing Abdominal Wall Defects in Rats

目的:观察小肠黏膜下层(small intestinal submucosa,SIS)和脱细胞心包(pericardium,PC)修复大鼠腹壁缺损的效果,比较两种生物材料相容性。方法:SD大鼠40只,体重200～250g,手术造成3 cm×2 cm全层腹壁缺损,随机分为二组(n=20),分别采用相同面积的小肠黏膜下层(small intestinal submucosa,SIS)和脱细胞真皮基质(acellular dermal matr,ADM)补片进行修补。术后1、2、4和8周分批取出腹壁修复材料,行动物一般情况观察、腹腔内粘连情况评价、力学强度测定及组织学观察。结果:术后动物都成活,两种材料术后8周均无疝瘘发生,缺损得到完整修复。术后各期SIS组的腹腔粘连评分明显低于PC组。术后4、8周,SIS组力学强度强于PC组,有统计学意义;组织学观察两组未见明显免疫排斥反应,SIS组的组织再生和重塑、血管化优于PC组;术后炎症反应两组无明显差异。结论:SIS和PC均能修复大鼠腹壁全层缺损,SIS在生物相容性方面优于PC。

Objective： To investigate the effects of small intestinal submucosa（SIS）and acellular pericardium（PC）on repairing wall defeats in rats,to compare compatibility of the two biological materials.Methods： A full-thickness 3cm×2cm abdominal wall defeat was created in 40 rats weight from 200 to 250g,then they were repaired with an interpositional implant（SIS,n=20;PC,n=20）.And the rats were harvested at week 1,week 2,week 4,and week 8 after operation.Animal general state of health,intra-abdominal adhesions and tensile strength were investigated.Results：All rats survived and the defeats were completely repaired by the materials without fistula or hernia.There were less adhesion in SIS group than that in PC group 4、8 weeks after operation,the tensile strength of abdominal wall in SIS group is stronger than that in PC group（p0.05）.No obvious immunoreaction was observed in two groups by histology.Remodeling and regeneration and vascularization of the abdominal wall were better in SIS group compared with PC group.There was not difference of inflammatory reaction of the two groups.Conclusion：Both SIS and PC were feasible to repair full-thickness abdominal wall defeat and SIS is superior to PC in regards to tissue compatibility.