摘要
目的观察研究基底膜生物补片应用于腹腔内修补(IPOM)大鼠腹壁部分层次缺损手术引导腹壁组织再生的过程。方法选取21只健康大鼠,建立腹壁部分层次缺损模型。3只作为对照组观察造模效果;18只在造模后,分别用4层和12层基底膜补片进行修补,每组各9只,于术后2、3、4周各取3只大鼠处死取其修复区及其周围组织进行观察,通过大体观察、组织病理染色、新生血管标记和间皮细胞免疫荧光标记,观察研究生物补片在修复早期引导腹膜和组织再生的基本过程和机制。结果补片植入术后2周的大体观察和新生血管标记结果表明基底膜生物补片显著促进组织的血管化,新生血管从补片网孔处向周围蔓延发散形成血供网络;HE和马松染色表明补片腹壁侧和腹腔侧有明显组织再生,新生组织从补片网孔处向周围蔓延,覆盖、包裹补片;间皮细胞免疫荧光标记表明,在腹腔侧新生组织表面形成扁平的连续间皮细胞层,即腹膜再生。结论IPOM腹壁修复中,基底膜生物补片在早期可以引导组织和腹膜再生,新生组织和血管通过网孔从腹壁侧向腹腔侧蔓延,并在补片表面形成组织层和连续的间皮细胞层,可以有效防止补片与内脏粘连的发生。
Objective To observe and study the process of peritoneal regeneration induced by basement membrane biologic mesh in rats with partial level defects in the abdominal wall via intraperitoneal onlay mesh(IPOM).Methods Twenty-one healthy rats were selected for the model construction of partial-level defects of the abdominal wall.After modeling,three rats were used as a control group to observe the modeling effect.Eighteen rats were repaired with 4-layer and 12-layer basement membrane biologic mesh,9 rats in each group.At 2,3 and 4 weeks postoperatively,three rats were killed to obtain and observe the repair area and its surrounding tissues.The peritoneal reconstruction and tissue repair process in early stage were evaluated by gross observation,histopathological staining,neovascularization labeling,and immunofluorescence labeling of mesothelial cells.Results Gross observation and neovascularization labeling two weeks after implantation showed that basement membrane biologic mesh could promote tissue vascularization.The neovascularization spread from the pore of mesh to the surrounding areas as blood supply.HE and Masson staining demonstrated significant tissue regeneration on the ventral wall side and peritoneal side of the mesh,with new tissue spreading peripherally from the mesh,and gradually cover and wrap the mesh.Immunofluorescence labeling of mesothelial cells demonstrated the formation of a flat,continuous layer of mesothelial cells on the surface of the new tissue on the peritoneal side,that is peritoneal regeneration.Conclusion During IPOM abdominal wall repair,the basement membrane biologic mesh can guide tissue regeneration and peritoneal reconstruction at an early stage.The new tissue spreads from the abdominal wall side to the abdominal cavity side through the mesh pores.Tissue layer and a continuous mesothelial cell layer was formed on the surface of the biologic mesh,effectively preventing the occurrence of adhesion of the mesh to the internal organs.
作者
仲卫冬
仲洁
代京
程文悦
张剑
Weidong Zhong;Jie Zhong;Jing Dai;Wenyue Cheng;Jian Zhang(First Department of General Surgery,Jiangyin City People's Hospital,Affiliated Jiangyin Hospital of Nantong University,Jiangyin,Jiangsu 214400,China;University of Shanghai for Science and Technology,School of Health Science and Engineering,Shanghai 200093,China;Department of Anorectal Surgery,the Second Affiliated Hospital of Naval Medical University(Shanghai Changzheng Hospital),Shanghai 200003,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2024年第2期139-145,共7页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
国防科技卓越青年科学基金(2019-JCJQ-ZQ-002)
国防科技基础加强计划(2019-JCJQ-JJ-069)。
关键词
基底膜
生物补片
腹腔内补片修补术
腹膜再生
间皮细胞
Basement membrane
Biologic mesh
Intraperitoneal onlay mesh(IPOM)
Peritoneal regeneration
Mesothelial cells
