CAJ | 학술논문

目的观察异种真皮来源的去细胞基质移植物(acellular matrix graft,ACMG)作为尿道狭窄重建手术替代材料应用于临床的安全性与有效性.方法将ACMG作为尿道重建的替代材料,观察尿路上皮细胞能否长入并形成通畅的新尿道以及有无排斥反应.采用ACMG治疗尿道狭窄病例10例,年龄20 ～ 62,平均36岁.狭窄长度3.0 ～15.0 cm,平均6.9 cm.术时采用狭窄段切除后ACMG尿道套入术或狭窄段切开后ACMG补片尿道修补术,术后6个月拔除尿管,观察该ACMG在人体中有无排斥反应及ACMG辅助尿道重建术的治疗效果. 结果 10例患者拔除尿管后均恢复排尿,尿道造影及尿道镜检查可见术后尿道连续性好,腔内黏膜连续.随访至术后18个月,出现尿道狭窄2例,经尿道内切开扩张后恢复正常排尿,其余患者均可通过尿道正常排尿. 结论异种真皮ACMG应用于尿道成形术中具有生物相容性良好、能从解剖上和功能上修复尿道的优点,适用于复杂、长段尿道狭窄病例的成形手术.
목적 관찰이충진피래원적거세포기질이식물(acellular matrix graft,ACMG)작위뇨도협착중건수술체대재료응용우림상적안전성여유효성.방법 장ACMG작위뇨도중건적체대재료,관찰뇨로상피세포능부장입병형성통창적신뇨도이급유무배척반응.채용ACMG치료뇨도협착병례10례,년령20 ～ 62,평균36세.협착장도3.0 ～15.0 cm,평균6.9 cm.술시채용협착단절제후ACMG뇨도투입술혹협착단절개후ACMG보편뇨도수보술,술후6개월발제뇨관,관찰해ACMG재인체중유무배척반응급ACMG보조뇨도중건술적치료효과. 결과 10례환자발제뇨관후균회복배뇨,뇨도조영급뇨도경검사가견술후뇨도련속성호,강내점막련속.수방지술후18개월,출현뇨도협착2례,경뇨도내절개확장후회복정상배뇨,기여환자균가통과뇨도정상배뇨. 결론 이충진피ACMG응용우뇨도성형술중구유생물상용성량호、능종해부상화공능상수복뇨도적우점,괄용우복잡、장단뇨도협착병례적성형수술.
Objective To investigate the clinical safety and validity of heterogeneous dermal acellular matrix graft (ACMG) for urethral reconstruction in patients. Methods Ten male patients aged 36( range,20 - 62),stricture length 6.9 cm ( range,3.0 - 15.0 cm),were treated with the ACMG material.During the operation,ACMG was sutured to a tubular graft or as a patch and replaced the defect urethra.Urinary catheter was inserted in the reconstructed urethra for 6 months.Then the outcomes of this operation method and whether there were rejections against the material were observed. Results All 10 patients could void through normal urethral,and no rejection was observed.Retrograde urethral visualization and urethroscope gave evidences of smooth urethral and continuous mucosa.The patients were followed up for 18months,and all patients voided normally except 2 cases needed urethral dilatation. Conclusions Heterogeneous dermal ACMG for urethroplasty in men has the excellence of good biocompatibility,constructing the functional urethra.Additionally,this material could be manufactured with greater scale and advanced technology,which made it appropriate for operation of harder and longer urethral stricture diseases,serving as an ideal replacement material of urethra.