应用聚丙烯与膨体聚四氟乙烯修补腹壁缺损的对比实验研究

Comparative evaluation of expanded polytetrafluoroethylene and polypropylene mesh used for repair of abdominal wall defect in rats

目的：对聚丙烯（ｐｏｌｙｐｒｏｐｙｌｅｎｅ Ｍｅｓｈ，ＰＰＭ）和膨体聚四氟乙烯（ｅｘｐａｎｄｅｄ ｐｏｌｙｔｅｔｒａｆｌｕｏｒｏｅｔｈｙｌｅｎｅ，ｅＰＴＦＥ）修补大鼠腹壁缺损的效果进行比较研究。方法：选用Ｗｉｓｔａｒ大鼠，手术造成腹壁缺损，分别采用ｅＰＴＦＥ和ＰＰＭ修补，术后分期进行腹壁抗张强度测定、腹腔内粘连评分以及组织学检察。结果：两种补片周围炎症反应均轻，无肉芽组织过度增生。ｅＰＴＦＥ引起的纤维增生反应较ＰＰＭ弱，周围炎症细胞密度在术后１４天后低于ＰＰＭ（Ｐ＜０．０５）。ｅＰＴＦＥ组腹壁抗张强度在术后７天弱于ＰＰＭ组（Ｐ＜０．０５），嗣后两组无显著性差异。ｅＰＴＦＥ的腹腔粘连程度明显较ＰＰＭ低。结论：两种补片都具有理化性质稳定、异物原性小的优点，术后均能维持足够的腹壁抗张强度。ｅＰＴＦＥ在组织相容性、抗腹腔粘连方面优于ＰＰＭ。

Objective: To compare expanded polytetrafluoroethyle ne (ePTFE) with polypropylene mesh(PPM) for repairing abdominal wall defect inrats.Methods: Full thickness defects of abdominal wall were created th rough surgery and were repaired with ePTFE and PPM in Wistar rats.At different postoperative time,animals were sacrificed and the tensile strength,the development of adhesions and histologic changes were observed and measured. Results:The inflammatory response was minimal with both prosthesis.ePTFE provoked less amount of inflammatory cells infiltration and less fibrous production than PPM. The tensile strength of abdominal wall in ePTFE group was lower than PPM group on the 7th day(P＜0.05), and there was no difference later.Adhesion was more marked in PPM group than that in ePTFE group.Conclusion: Both prosthesis are chemically and physically stable and histologically compatible.The tensile strength of abdominal wall can be maintained sufficiently after the repair.ePTFE was superior to PPM in regards to tissue compatibility and adhesion formation.