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纳米仿生防粘连复合补片修复大鼠腹壁缺损中胶原合成功能的研究
中文摘要

目的:本实验通过应用纳米仿生、防粘连复合型疝补片于大鼠腹壁缺损模型进行疝修补实验,观察大鼠术后一般情况、术区组织生长大体情况、组织病理、组织蛋白表达等多个方面,与传统的聚丙烯、聚酯补片比较,评估纳米仿生、防粘连复合型疝补片修复腹壁疝的胶原蛋白合成功能的优劣,为临床提供实验依据。 方法:成年SD大鼠90只,体重介于150-200g之间,随机分为3组:NT组(纳米仿生、防粘连复合型疝补片),PP组(聚丙烯补片)及PE组(聚酯补片),构建腹壁疝模型。根据分组将大小约3*2㎝的三组补片缝合于腹壁缺损处。术后观察大鼠一般情况,分别于术后4、6、8周处死大鼠各10只,大体观察腹腹壁手术区域组织形成情况;切取补片及其周围组织进行组织学观察,分析胶原蛋白表达情况,并进行Western bolt分析各组腹壁修复区域Ⅰ型胶原蛋白及Ⅲ型胶原蛋白表达量。 结果:各组大鼠术后一般情况均良好,未出现死亡等不良事件;腹壁手术区域,NT组触感柔软,异物感较少,未见明显腹腔脏器突出;PP组触感较僵硬,皮下可见大量新生血管长入,异物感较重;PE组大鼠腹壁修复区触感僵硬,皮下可见较多新生血管长入。组织学观察:术后各个时间点,NT组修补效果优于PP、PE组,NT组Ⅰ型胶原表达更多,Ⅲ胶原表达更少,比例更加合理,纤维结构更加成熟稳定。组织蛋白含量:随着时间推移,术后各组Ⅰ型胶原蛋白随着时间进展逐步增加,而且NT组在各个时间点明显高于PP组及PE组,有统计学差异;术后6周及术后8周NT组的Ⅰ/Ⅲ型胶原蛋白比例基本保持在4:1左右,较术后4周明显增加,而且在各个时间点上NT组均高于PP、PE组,有统计学差异。 结论:在常规腹壁缺损无张力修补术过程中,纳米仿生、防粘连复合型疝补片在组织重构过程中比聚丙烯补片及聚酯补片更早形成成熟稳定的纤维结构,提供更加稳固的修复效果,适用于目前常规的腹壁疝修补,尤其是巨大腹壁缺损引起的腹壁疝,但长期使用的效果及其安全性的评价仍需进一步明确。 关键词:腹壁疝;复合补片;纳米仿生材料;大鼠;组织重构性

英文摘要

Objective: In this study, the application of nano-bionic, anti-adhesive compound hernia patch in the rat abdominal wall defect model of hernia repair test to observe the general situation after surgery, surgical tissue growth in general, histopathology, tissue protein expression and other aspects , Compared with the traditional polypropylene, polyester patch, to assess the nano-bionic, anti-adhesive composite hernia patch repair abdominal hernia tissue reshaping the merits of the prospective, to provide experimental basis for clinical. Methods: Total ninety adult SD rats weighing between 150-200 g were randomly divided into three groups: NT group (nano-bionic, anti-adhesion compound hernia repair patch), PP group (polypropylene patch) and PE group (poly Ester patch), the construction of abdominal hernia model.Three sets of patches of about 3 * 2 ㎝ in size were sutured to the abdominal wall defect according to the groups. The rats in the rats were sacrificed at 4, 6 and 8 weeks after operation. The histological observation was performed on the patch and the surrounding tissues. Using the Western blot analysis the expression of type I collagen and type III collagen in the abdominal wall repair area of each group. Results: After the operation, each group of rats were generally good, without appear death and other complications. In the abdominal surgery area, the tactile sensation of the NT groups were less, the sensation of the foreign body was also less, and no obvious abdominal organ protrusion was found. The PP groups had a stronger sense of touch and a large number of neovascularization in the skin. The foreign body sensation was heavier and subcutaneous visible more new blood vessels grow into in the PE groups. Histology observation: The effect of NT group was better than that of PP, PE group and NT group , with more type I collagen expression and less type III collagen expression, the proportion is more reasonable, more mature and stable fiber structure. The content of tissue protein: the content of type I collagen in each group was gradually increased with the passage of time. NT group was significantly higher than those of PP group and PE group at each time point, with the statistic difference. The ratio of I / III collagen in NT group was about 4: 1 after 6 weeks and 8 weeks after operation , Which was significantly increased at 4 weeks after operation, and there was significant difference between NT group and PP group at each time point. Conclusion: In the course of tension-free repair of abdominal wall defects, the nano-bionic, anti-adhesive compound hernia patch could be earlier to form a mature and stable fiber structure, to provide a more solid Repair effect in the process of tissue remodeling, compared with the polypropylene patch and polyester patch. It applies to the current conventional abdominal hernia repair, especially the large abdominal wall hernia caused by abdominal wall defects. But the long-term use of the effect and safety evaluation still need to be further clarified. Key Words: abdominal wall hernia; composite patch; nano biomimetic material; rat; tissue remodelling

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