复合生物支架胶原蛋白/壳聚糖及聚乙烯醇/丝胶在大鼠膀胱扩大手术中的应用

Evaluation of Composite Biomaterial Collagen/Chitosan and Polyvinyl Alcohol/Sericin as Tissue Engineering Scaffold in Rat Bladder Augmentation

目的评价复合生物材料胶原蛋白/壳聚糖及聚乙烯醇/丝胶在膀胱扩大手术中的效果及可行性。方法雌性大鼠21只随机分为3组,即膀胱扩大手术组(实验组:修补材料为胶原蛋白/壳聚糖+聚乙烯醇/丝胶);膀胱部分切除组(对照组)和非手术组(平行对照组)。所有3组实验动物在术后7 d、21 d、42 d进行膀胱容量测定,并取材观察其形态学及组织学改变。结果接受膀胱扩大手术的大鼠,术后各时间点的膀胱容量均明显高于其他两组。大体检查见膀胱血管纹理清晰,修补部位与正常膀胱无明显分界,结石发生率为71.4%。镜下组织学检查发现:术后7 d时,支架外层大量炎症细胞浸润,组织结构无法分清。术后42 d时,支架内层上可见泌尿上皮呈多层排列,黏膜下层增厚明显,但平滑肌层相对稀疏且排列欠规则。结论复合生物支架胶原蛋白/壳聚糖+聚乙烯醇/丝胶能成功应用于大鼠膀胱扩大手术,但存在膀胱平滑肌层再生情况不佳、成石率较高的缺点,有待进一步研究改善。

Objective To evaluate the efficacy of composite biomaterial collagen/chitosan and polyvinyl alcohol/sericin as tissue engineering scaffold in bladder augmentation in rat model. Methods Twenty-one Sprague-Dawley rats were divided into 3 groups： bladder augmentation operative group （experimental goup： repaired with eollagen/chitosan and polyvinyl alcohol/sericin）, partial eystectomy group （control group） and non-operative group （blank control group）. Bladder volume, morphological change and histological change were evaluated 7, 21, and 42 days after surgez7. Results The bladder volume in bladder augmentation operative group was magnificently higher than partial cystectomy group and non-operative group. Grossly, the vessel texture was clear and there was no significant difference between normal bladder wall and repair parts. The prevalence of bladder stone was 71.4%. Under microscope, structure was hardly be distinguished 7 days after surgery due to a large number of inflammatmy cell infiltration. After 42 days, muhi-layer arrangement of urothelial was seen on the inner layers of the stent, however, the smooth muscle layer was relatively sparse and arranged irregularly. Conclusion Composite biomaterial collagen/chitosan and polyvinyl alcohol/sericin can be used in bladder augmentation in rat model. However, the prevalence of bladder stone is relatively higher and the growth of bladder smooth muscle cell is not so good. Further investigation should be performed.