CAJ | 학술논문

目的观察聚丙烯补片经丝素蛋白涂覆后,其表面粘连程度的变化,并探讨其作用机制.方法将40只Sprague-Dawle大鼠随机分为两组,每组各20只.按组于腹腔内分别植入丝素蛋白涂覆聚丙烯材料(丝素面朝向腹腔,聚丙烯面朝向腹壁)和聚丙烯补片,于术后3、7、14、90 d分批处死大鼠,比较植入补片表面粘连程度及粘连面积,并行病理及扫描电镜检查.结果丝素蛋白涂覆聚丙烯材料组,术后3、7、14、90d检查基本无腹腔内粘连形成,补片表面粘连面积占总面积的(6.04±4.78)%,粘连程度为(0.8±0.4);单纯聚丙烯组全部大鼠术后并发腹腔内粘连面积占总面积的(86.61±12.25)%,粘连程度为(3.4±0.6),有5只(5/20,25.0%)大鼠分别于术后2～9d因肠管与聚丙烯粘连引起肠梗阻或肠瘘死亡,两组的术后腹腔内粘连面积和粘连程度差异均存在统计学意义(P均<0.05).结论丝素材料能促进腹膜间皮细胞长入,于聚丙烯补片表面腹膜化,形成新的间皮细胞层,可有效降低聚丙烯补片与腹腔内器官发生粘连的程度及范围.
목적 관찰취병희보편경사소단백도복후,기표면점련정도적변화,병탐토기작용궤제.방법 장40지Sprague-Dawle대서수궤분위량조,매조각20지.안조우복강내분별식입사소단백도복취병희재료(사소면조향복강,취병희면조향복벽)화취병희보편,우술후3、7、14、90 d분비처사대서,비교식입보편표면점련정도급점련면적,병행병리급소묘전경검사.결과 사소단백도복취병희재료조,술후3、7、14、90d검사기본무복강내점련형성,보편표면점련면적점총면적적(6.04±4.78)%,점련정도위(0.8±0.4);단순취병희조전부대서술후병발복강내점련면적점총면적적(86.61±12.25)%,점련정도위(3.4±0.6),유5지(5/20,25.0%)대서분별우술후2～9d인장관여취병희점련인기장경조혹장루사망,량조적술후복강내점련면적화점련정도차이균존재통계학의의(P균<0.05).결론 사소재료능촉진복막간피세포장입,우취병희보편표면복막화,형성신적간피세포층,가유효강저취병희보편여복강내기관발생점련적정도급범위.
Objective To explore the merits of polypropylene ( PP) mesh coated with silk fibroin in promoting mesothelial cell hyperplasia, and reducing abdominal adherence. Methods Forty male Spra-gue-Dawle rats were divided randomly as follows: group 1, PP mesh coated with silk fibroin (n = 20) , group 2, pure PP mesh (n=20). Repair operation was performed on the rats through abdominal cavity with PP mesh coated with silk fibroin (the silk to organ, and the PP to abdominal wall), or without silk fibroin. All the rats were executed in 3 , 7, 14 and 90 days postoperatively for histopathological and scanning electron microscopic examinations. The quality and quantity of the adherence between mesh and abdominal organs or tissues were measured. Such complications as death, intestinal fistula or obstruction were documented. Results In group 1, there was no obviously adherence on the PP meshes coated with silk fibroin , the area of the adherence on the mesh was calculated as (6. 04 ± 4.78) % and the quality of the adherence as (0. 8 ±0.4) ; In group 2, 5 rats died in 2, 4, 6, 7, 9 days postoperatively complicated by intestinal fistula or obstruction with serious adherence between the mesh and the intestine. The area of the adherence on the mesh was calculated as (86. 61 ± 12. 25) % and the quality of the adherence as (3.4±0.6). Conclusion Silk fibroin can promote mesothelial cells agglutination and reform peritoneum on the PP mesh, and effectively decrease the quality and quantity of the adherence postoperatively.