两种生物材料修补大鼠腹壁缺损的组织学反应

Experimental study on histological reaction of the two biomaterials in repairing abdominal wall defect

目的:观察聚丙烯(Polypropylene,PP)和复合材料(Polypropylene+ex-pandedPolytetrafluoroethylene,PP+ePTFE)修补大鼠腹壁缺损的组织学反应,客观地评价两种材料的特点,以便为临床选用材料提供一定的理论依据。方法:Wistar大鼠分为PP全层修补(PP-T)组、PP保留腹膜(PP-PR)组和PP+ePTFE全层修补(PP+ePTFE-T)组。切除1.5cm(2.0cm的前腹壁,分别以相同面积的两种补片修补缺损,于术后14,30,60和120d进行腹腔内粘连评分及组织学检查。结果:PP+ePTFE组动物术后各期腹腔粘连明显轻于PP+T组(分别P<0.05)。PP+PR组动物腹腔无粘连。术后14d,两种材料周围均以炎性反应为主,但PP+ePTFE组腹腔面反应很轻。30d后,在PP和PP+ePTFE非腹腔面周围成纤维细胞和胶原逐渐增加。PP+ePTFE材料的腹腔面逐渐形成一间皮层。结论:PP材料与组织掺和好,但与腹腔粘连重。PP+ePTFE材料既有组织掺和好,又具有抗腹腔粘连作用。腹膜是防止PP材料与腹腔脏器粘连的最好屏障。

AIM:To observe Histological reaction of Polypropylene(PP) and composite materials(Polypropylene ? expanded polytetrafluoroethylene,PP? ePTFE) in repairing abdominal wall defect in rats and evaluate the characteristics of two materials objectively so as to provide clinical theory. METHODS:Wistar rats were divided into 3 groups:PP total layer repair(PP T), PP peritoneum reserved repair(PP PR)and PP? ePTFE total layer repair(PP? ePTFE T).Full thickness defects(1.5 cm× 2.0 cm) of anterior abdominal wall were established through surgery and were repaired with PP or PP? ePTFE in Wistar rats. The animals were scrificed and the development of adhesions and histologic changes were observed on 14, 30, 60 and 90 days postoperatively. RESULTS:Adhesion was significantly less in PP? ePTFE group than that in PP? T group at different time points postoperatively(P< 0.05)The inflammatory response surrounding the two materials mainly appeared while less amount of inflammatory cell was observed on the abdominal cavity face of PP? ePTFE on postoperative 14 days. Formation of fibroblasts and collagen surrounding PP and the non abdominal cavity face of PP? ePTFE increased gradually while formation of mesothelial layer on the abdominal cavity face of PP? ePTFE was observed after postoperative 30 days.