中国生育健康杂志
中國生育健康雜誌
중국생육건강잡지
CHINESE JOURNAL OF REPRODUCTIVE HEALTH
2014年
4期
322-325
,共4页
徐浩%陈明%吴丽英%王振龙%宓立强
徐浩%陳明%吳麗英%王振龍%宓立彊
서호%진명%오려영%왕진룡%복립강
腹股沟疝%精索%精子活力%膨体聚四氟乙烯网片
腹股溝疝%精索%精子活力%膨體聚四氟乙烯網片
복고구산%정색%정자활력%팽체취사불을희망편
Inguinal hernia%Spermatic cord%Sperm viability%Expanded polytetrafluoroethylene mesh
目的：通过大鼠实验动物模型，对比研究聚丙烯网片、膨体聚四氟乙烯网片在开放性无张力疝修补术后与精索的粘连情况及其对精子活力和睾丸HIF-1α的影响。方法将32只成年雄性大鼠，随机分成4组，每组8只，分别给予正常对照、假手术、聚丙烯网片和膨体聚四氟乙烯网片开放性无张力疝修补术。术后90 d观察大鼠腹股沟区粘连程度；免疫组化法测睾丸低氧诱导因子（HIF-1α）；取附睾内精液检测大鼠精子活率。结果各组术后一般情况良好。膨体聚四氟乙烯组疝网片与精索无粘连或轻度粘连，聚丙烯网片组疝网片与精索粘连较严重；聚丙烯网片组HIF-1α表达强度[（85.8±20.9）×10-3]显著升高，与正常组[（2.3±0.6）×10-3]比较，差异有统计学意义；膨体聚四氟乙烯组HIF-1α表达强度[（4.2±2.7）×10-3]与假手术组[（2.6±0.7）×10-3]、正常组比较，差异无统计学意义。假手术组（69.83％±8.83％）、膨体聚四氟乙烯组精子活率（63.90％±6.23％）与正常组（80.32％±4.33％）比较，差异无统计学意义；聚丙烯网片组精子活率（37.25％±11.54％）降低，与正常组、假手术组比较，差异有统计学意义。结论不同材料疝网片对雄性大鼠的生殖功能影响不同，重型聚丙烯网片影响较大，膨体聚四氟乙烯网片影响较小。建议年轻患者应用传统的Shouldice法进行修补，必须行无张力修补术者应使用膨体聚四氟乙烯网片。
目的：通過大鼠實驗動物模型，對比研究聚丙烯網片、膨體聚四氟乙烯網片在開放性無張力疝脩補術後與精索的粘連情況及其對精子活力和睪汍HIF-1α的影響。方法將32隻成年雄性大鼠，隨機分成4組，每組8隻，分彆給予正常對照、假手術、聚丙烯網片和膨體聚四氟乙烯網片開放性無張力疝脩補術。術後90 d觀察大鼠腹股溝區粘連程度；免疫組化法測睪汍低氧誘導因子（HIF-1α）；取附睪內精液檢測大鼠精子活率。結果各組術後一般情況良好。膨體聚四氟乙烯組疝網片與精索無粘連或輕度粘連，聚丙烯網片組疝網片與精索粘連較嚴重；聚丙烯網片組HIF-1α錶達彊度[（85.8±20.9）×10-3]顯著升高，與正常組[（2.3±0.6）×10-3]比較，差異有統計學意義；膨體聚四氟乙烯組HIF-1α錶達彊度[（4.2±2.7）×10-3]與假手術組[（2.6±0.7）×10-3]、正常組比較，差異無統計學意義。假手術組（69.83％±8.83％）、膨體聚四氟乙烯組精子活率（63.90％±6.23％）與正常組（80.32％±4.33％）比較，差異無統計學意義；聚丙烯網片組精子活率（37.25％±11.54％）降低，與正常組、假手術組比較，差異有統計學意義。結論不同材料疝網片對雄性大鼠的生殖功能影響不同，重型聚丙烯網片影響較大，膨體聚四氟乙烯網片影響較小。建議年輕患者應用傳統的Shouldice法進行脩補，必鬚行無張力脩補術者應使用膨體聚四氟乙烯網片。
목적：통과대서실험동물모형，대비연구취병희망편、팽체취사불을희망편재개방성무장력산수보술후여정색적점련정황급기대정자활력화고환HIF-1α적영향。방법장32지성년웅성대서，수궤분성4조，매조8지，분별급여정상대조、가수술、취병희망편화팽체취사불을희망편개방성무장력산수보술。술후90 d관찰대서복고구구점련정도；면역조화법측고환저양유도인자（HIF-1α）；취부고내정액검측대서정자활솔。결과각조술후일반정황량호。팽체취사불을희조산망편여정색무점련혹경도점련，취병희망편조산망편여정색점련교엄중；취병희망편조HIF-1α표체강도[（85.8±20.9）×10-3]현저승고，여정상조[（2.3±0.6）×10-3]비교，차이유통계학의의；팽체취사불을희조HIF-1α표체강도[（4.2±2.7）×10-3]여가수술조[（2.6±0.7）×10-3]、정상조비교，차이무통계학의의。가수술조（69.83％±8.83％）、팽체취사불을희조정자활솔（63.90％±6.23％）여정상조（80.32％±4.33％）비교，차이무통계학의의；취병희망편조정자활솔（37.25％±11.54％）강저，여정상조、가수술조비교，차이유통계학의의。결론불동재료산망편대웅성대서적생식공능영향불동，중형취병희망편영향교대，팽체취사불을희망편영향교소。건의년경환자응용전통적Shouldice법진행수보，필수행무장력수보술자응사용팽체취사불을희망편。
Objective To compare the effects of polypropylene mesh (PP)and expanded polytetrafluoroethylene mesh (e-PTFE)meshe on the adhesion with spermatic cord and sperm viability and testicular HIF-1αexpression in the open tension-free hernioplasty in rats. Methods Thirty-two male SD rats were randomly divided into 4 groups:the normal control group (NC),the sham operation group (SO),the PP)and the e-PTFE group.At day 90,we observed postoperative general situation and degree of adhesion of spermatic cord around the meshes in each group;we took testicular tissue of operative side to measure the HIF-1αexpression by IHC,and we measured sperm viability by sperm counting. Results General situations in 4 groups were all well.No or mild adhesion was observed in the e-PTFE group,but severe adhesion between the hernia mesh and the spermatic cord in the PP group.The expression of HIF-1αwas significantly elevated in the PP group [(85.8 ±20.9)×10 -3 ]compared with the NC group [(2.3 ±0.6)×10 -3 ].Expression of HIF-1αin the e-PTFE group [(4.2 ±2.7)×10 -3 ]was neither different from the NC nor the SO group [(2.6 ±0.7)× 10 -3 ].There were not statistical significances in sperm viability between the NC (80.32%±4.33%),SO (69.83%± 8.83%)and e-PTFE group (63.90% ±6.23%).The sperm viability of the PP group (37.25% ±11.54%)was significantly lower compared with the SO or e-PTFE group. Conclusion Effects on the reproductive function of male rats were observed when applying tension-free hernioplasty with hernia meshes.The effects varied by types of meshes,with PP the greatest while e-PTFE the slightest.It is recommend to employ Shouldice instead of tension-free hernioplasty with hernia meshes;nevertheless the application of e-PTFE mesh is acceptable when the surgery is obligatory.
