CAJ | 학술논문

目的观察应用新型生物补片在腹外疝修补术中减轻局部和全身炎性反应的作用.方法建立18只家兔腹外切口疝模型,分为3组:实验组应用新型生物补片进行修补,对照组为聚丙烯补片,空白组为单纯缝合；检测3组术前及术后3、7、14、21、28 d血常规、肝肾功能的变化；酶联免疫吸附试验(ELISA)检测3组术前及术后3、7、14、21、28 d血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β的变化；4周后检测局部补片粘连并行免疫组织化学检查.结果 3组兔术后均未出现死亡及感染等并发症.3组白细胞数术后均升高,但实验组较对照组白细胞升高明显减轻,差异有统计学意义[(10.562±0.367)×109/L＜(11.785±0.452)×109/L,P＜0.05],与空白组兔差异无统计学意义(P＞0.05)；3组肝肾功能变化差异无统计学意义；实验组及对照组TNF-α较空白组明显升高(P＜0.05),术后实验组TNF-α较对照组明显降低[(54.33 ±8.17) μg/L＜ (94.67 ±13.02)μg/L,P＜0.05],术后14 d时差异最大[(178.59 ±21.51) μg/L＞ (88.24±14.57) μg/L＞ (65.35±17.37) μg/L,P＜0.05]；3组中IL-1β的表达变化与TNF-α相同.大体标本观察和免疫组织化学结果显示,实验组由生物补片形成的粘连评分明显小于对照组(5 ＜17,P＜0.05),实验组出现少量异物巨细胞反应.结论新型生物补片植入后,仍可引起一定的全身及局部炎性反应,但远较传统聚丙烯补片轻,其生物相容性优于传统聚丙烯补片.
목적 관찰응용신형생물보편재복외산수보술중감경국부화전신염성반응적작용.방법 건립18지가토복외절구산모형,분위3조:실험조응용신형생물보편진행수보,대조조위취병희보편,공백조위단순봉합；검측3조술전급술후3、7、14、21、28 d혈상규、간신공능적변화；매련면역흡부시험(ELISA)검측3조술전급술후3、7、14、21、28 d혈청종류배사인자(TNF)-α、백세포개소(IL)-1β적변화；4주후검측국부보편점련병행면역조직화학검사.결과 3조토술후균미출현사망급감염등병발증.3조백세포수술후균승고,단실험조교대조조백세포승고명현감경,차이유통계학의의[(10.562±0.367)×109/L＜(11.785±0.452)×109/L,P＜0.05],여공백조토차이무통계학의의(P＞0.05)；3조간신공능변화차이무통계학의의；실험조급대조조TNF-α교공백조명현승고(P＜0.05),술후실험조TNF-α교대조조명현강저[(54.33 ±8.17) μg/L＜ (94.67 ±13.02)μg/L,P＜0.05],술후14 d시차이최대[(178.59 ±21.51) μg/L＞ (88.24±14.57) μg/L＞ (65.35±17.37) μg/L,P＜0.05]；3조중IL-1β적표체변화여TNF-α상동.대체표본관찰화면역조직화학결과현시,실험조유생물보편형성적점련평분명현소우대조조(5 ＜17,P＜0.05),실험조출현소량이물거세포반응.결론 신형생물보편식입후,잉가인기일정적전신급국부염성반응,단원교전통취병희보편경,기생물상용성우우전통취병희보편.
Objective To study the application of the new biological mesh for herniorrhaphy to alleviate the postoperative inflammation.Methods In 18 New Zealand rabbits,muscle-thickness abdominal wall defect models were established,and randomly assigned to one of three groups:repaired by biomaterials patch (experimental group,EP),repaired by polypropylene mesh group (control group,CP),and repaired without any mesh (negative control group,NP).The number of white blood cells (WBCs),and the liver and renal functions were examined preoperatively and on the postoperative day 3,7,14,21 and 28 in each group.The expression of tumor necrosis factor (TNF)-α and interleukin (IL)-1β was detected simultaneously by using enzyme linked immunosorbent assay (ELISA).All animals were sacrificed after four weeks and the local adhesion was measured.Results There was no abdominal incision infection and death in three groups.The WBCs in each group were increased,and reached the peak at lst-2nd week,and there was significant difference between EP and CP [(10.562 ±0.367) × 109/L vs.(11.785 ±0.452) ×109/L,P ＜ 0.05],but no significant difference between EP and NP.The liver and renal functions among groups had no significant difference after the surgery.The levels of TNF-α and IL-1β in EP and CP were significantly increased as compared with NP (P ＜ 0.05),those in EP after surgery were significantly reduced as compared with CP (P ＜ 0.05),and the difference reached the peak at 2nd week post-operation (P ＜ 0.05).There was lower grade of adherence in EP than in CP after four weeks (5 ＜ 17,P ＜ 0.05).Immunohistochemistry showed biomaterials patch could cause less giant cell reaction.Conclusion This new biological mesh still can cause systemic and local inflammatory response,but much lighter than traditional polypropylene mesh.Its biocompatibility is far superior to that of traditional polypropylene mesh.