生物型补片修补中孕期胎羊腹壁缺损

Biomatrix patch for abdominal defect repair in the mid-trimester fetal lambs

背景:腹裂在胚胎早期就已出现,由其引起的肠管损伤和功能障碍贯穿胎儿发育的全程。目的:探讨在中孕期进行宫内手术修补胎羊腹壁缺损的可行性。方法:取8只妊娠75～80d的健康单胎妊娠山羊。将其分为两组,拉拢缝合组3只,采用拉拢缝合腹壁的方法修复胎羊腹壁的缺损。生物型膜片组5只,采用两层生物型膜片修补腹壁缺损。两组羔羊自然分娩,对其腹壁进行病理学检查。结果与结论:拉拢缝合组3只羔羊均顺利娩出,3只羔羊腹壁切口愈合好,瘢痕呈线样,腹内粘连轻。组织切片上见瘢痕轻微。生物型膜片组5只中有1只流产,4只羔羊顺利娩出,4只羔羊腹壁切口愈合好,瘢痕明显,腹内粘连轻。组织切片上主要为纤维结缔组织。结果提示,在中孕期进行胎羊腹壁缺损是完全可行的。胎羊腹壁直接进行缝合者愈合后瘢痕轻微。对于皮肤缺损较大者,生物型修补膜片是一种可行性材料。

BACKGROUND：Gastroschisis is a rare and serious congenital abdominal wall defect disease,and often leads to the development imbalance between the intestine and abdominal cavity with inflammatory thickened bowel.OBJECTIVE：To evaluate the feasibility of intrauterine abdominal defect repair of fetal lamb in the mid-trimester.METHODS：Eight healthy pregnant ewes（at 75-80 days of gestation,with single fetus） were divided into 2 groups.Group 1（3 lambs）：the abdominal wall defect was closed by strengthening suture;Group 2（5 lambs）：the abdominal wall defect was repaired by two layers of biomatrix.After the lambs delivered naturally,the abdominal walls were examined pathologically.RESULTS AND CONCLUSION：Three lambs of group 1 were successfully delivered,the abdominal incision healed well with a line-like scar,intra-abdominal adhesions was minor.A slight scar was seen on the tissue section.One lamb of the group 2 aborted,while 4 lambs delivered,the abdominal incision of the four lambs healed with obvious scar,intra-abdominal adhesions was minor.The fiber connective tissue was seen mainly on the tissue section.It was feasible to repair the abdominal wall defect of fetal lamb in mid-trimester.For fetal lamb,the abdominal wall scar was minor after direct suture.For larger abdominal wall defect,biomatrix patch was a promising material.