摘要
目的探讨引导组织再生(guide tissue regeneration,GTR)胶原蛋白膜用于大鼠胃壁全层缺损修复的可行性及有效性。方法 33只SD大鼠分为实验组(n=25)和对照组(n=8),建立胃壁全层穿孔模型,分别应用GTR胶原蛋白膜或聚乳酸(polylactic acid,PLA)膜修补。观察术后大鼠食欲、体重变化及体温,有无腹胀、腹泻及腹膜炎表现。实验组大鼠分别于术后3天、1周、2周、4周、6周处死(每次5只),对照组于术后6周处死,观察穿孔创面愈合、腹腔粘连、腹腔感染,并取穿孔部位组织进行组织病理分析。结果①33只SD大鼠均成功完成胃穿孔建模及修复术。对照组3只大鼠于术后3天内死亡(穿孔修补部位再次穿孔),实验组25只术后活动正常,食欲、体重及体温未见明显异常,无腹胀腹泻,无腹腔脓肿及消化道漏,实验组存活率[100%(25/25)]明显高于对照组[62. 5%(5/8)](Fisher检验,P=0. 010)。②实验组术后1周胃壁全层缺损闭合,黏膜面黏膜缺损面积(39. 79±0. 55) mm^2,术后2周黏膜缺损面积(7. 40±0. 43) mm^2,术后4周黏膜缺损面积(0. 91±0. 08) mm^2,术后6周黏膜完全再生,黏膜下层及肌层组织趋于正常化。对照组术后6周黏膜缺损面积(1. 39±0. 20) mm^2,显著大于实验组术后4周黏膜缺损面积(t=-5. 029,P=0. 001)。结论 GTR胶原蛋白膜作为修复骨架可有效促进细胞爬行和再生,可快速修补胃穿孔并促进愈合,再生组织无明显瘢痕,实现缺损组织和结构复原,修复效果明显优于PLA膜。
Objective To investigate the feasibility and efficacy of guide tissue regeneration ( GTR) collagen membrane for repairing full-thickness defects of rat stomach.Methods A total of 33 SD rats were divided into either experimental group ( n = 25) or control group ( n = 8).The rats were used to establish full-thickness defects model of the gastric wall, and then respectively repaired by the GTR collagen patches or polylactic acid ( PLA) patches.The rats’ appetite, body weight, and body temperature were observed, as well as abdominal distension, diarrhea and peritonitis.The rats in the experimental group were randomly divided into 5 subgroups: postoperative 3 days group, postoperative 1 week group, postoperative 2 weeks group, postoperative 4 weeks group, and postoperative 6 weeks group, which were sacrificed at corresponding time.The rats in the control group were sacrificed at 6 weeks after the surgery.The healing of perforated wounds, abdominal adhesions, abdominal infections were compared after being sacrificed at the corresponding time.The defect regions were collected for histopathological analysis.Results ① All the 33 SD rats with stomach defect were successfully repaired.A total of 3 rats in the control group died within 3 days ( perforation happened again in the repaired places).All the rats in the experimental group ( n = 25) survived well until being sacrificed at corresponding time, with no abnormity in appetite, body weight or body temperature.And no abdominal distension, diarrhea, abdominal abscess or digestive tract leakage happened.The survival rate was much higher in the experimental group [100%(25 /25)] than the control group [62.5%(5 /8)]( Fisher’ s exact test, P = 0.010).②One week after surgery, the perforation was closed and the mucosal surface defect area was (39.79±0.55) mm^2 in the experimental group.The mucosa defect area was (7.40 ± 0.43) mm^2 at the second week and (0.91±0.08) mm^2 at the fourth week.Six weeks after the surgery, the mucosal achieved complete regeneration.The struc
作者
翟文斌
赵黎黎
陈颖彤
陈嘉伟
刘莉
王敏
王翔
范志宁
Zhai Wenbin;Zhao Lili;Chen Yingtong(Digestive Endoscopy Department, First Affiliated Hospital ofNanjing Medical University, Nanjing 210029, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2019年第4期330-335,共6页
Chinese Journal of Minimally Invasive Surgery
基金
国家自然科学基金(81700577)
江苏医学重点专科(ZDXKA2016005)
江苏省"333"工程基金(BRA2015463)
江苏高校优势学科建设工程资助项目(JX10231802)
关键词
SD大鼠
胃穿孔
胶原蛋白膜
组织再生
SD rat
Stomach perforation
Collagen membrane
Tissue regeneration
