聚丙烯网片非感染状态下生物相容性的病理及超微结构研究

A Study on Pathology and Ultrastructure of Polypropylene Mesh Implanted in Non-infected Rabbits and Its Biocompatibility

目的:观察非感染状态下医用聚丙烯网片在动物体内1～6个月生物相容性的病理改变及超微结构变化。方法:在6只清洁级新西兰家兔腹部皮下植入10 mm×40 mm的医用聚丙烯网片各10条,共计60条;按随机数字表分为3组,分别于术后30 d(A组)、90 d(B组)及180 d(C组)取出网片及同周围组织,以家兔假手术部位的皮肤及皮下组织作自身对照(D组);用游标卡尺测量植入前网片长宽值以及植入后不同时间取出网片-组织长宽值,计算面积比值算出缩变率;光镜下观察炎症反应、纤维囊形成情况,参照GB/T16886.6-1997Ⅰ～Ⅳ分级,评价植入网片的生物相容性;扫描电镜观察网片与机体组织的融合情况。结果:实验家兔均未见感染、侵蚀、暴露;A、B、C组网片缩变率分别为(4.5±1.4)%、(5.0±2.0)%、(6.7±2.2)%,C组网片缩变率最大,与A、B组相比P<0.05,A组与B组相比P>0.05;A、B、C、D炎症反应分别为Ⅱ级、<Ⅰ级、<Ⅰ级、<Ⅰ级,纤维囊形成级别分别为Ⅱ级、<Ⅰ级、<Ⅰ级、<Ⅰ级,各组均未见组织萎缩及伊红变性;扫描电镜下各组均见结缔组织包绕网丝,纤维囊厚度随时间延长而变薄,各组网丝表面未见破裂、磨损。结论:医用聚丙烯网片缩变率随时间延长而增大,医用聚丙烯网片在一定时期内具有较好的生物相容性。

Objective：To observe the changes of pathology and ultrastructure of polypropylene mesh implanted in non-infected rabbits for one to six months,and to evaluate its biocompatibility.Methods：Sixty pieces of 10 mm×40 mm sized polypropylene meshes were implanted into subcutaneous tissues of 6 New Zealand white rabbits respectively.The rabbits were randomly divided into three groups（two in each group）.Meshes and circa-subcutaneous tissues were explanted after 30 days（group A）,90 days（group B） and 180 days（group C）.Subcutaneous tissues of sham operation areas were also explanted as control group（group D）.Length and width values of the meshes were determined with sliding caliper.Shrinkage rate was calculated.Inflammatory response and fibrous capsule formation condition were observed by light microscopy and graded according to GB/T16886.6-1997.The biocompatibility was also evaluated.Confluence conditions of meshes and tissues were observed with scanning electron microscope（SEM）.All measurement data were analyzed using variance analysis with P0.05 as significant level.Results：There was no sign of infection,erosion or exposure in operation sites of all the rabbits.Shrinkage rates of the meshes were 4.5%±1.4%,5.0%±2.0% and 6.7%±2.2% in groups A,B,and C respectively.The shrinkage rate of group C was the biggest,and was significantly different from those of groups A,and B（P0.05）,while there was no statistically significant difference between groups A and B（P0.05）.Pathological study showed that both inflammation and fibrous capsule formation grading were class II in group A,and class I in groups B,C,and D.There was no obvious atrophic changes or eosin degeneration in tissues of all the groups.Ultrastructural study showed that connective tissue well encased the meshes and fibrous capsule became thinner with time passing.No fracture or abrasion was found in mesh fiber.Conclusions：Shrinkage rate of polypropylene mesh becomes bigger with time passing,and it presents good biocompatibility in a certain period.