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异体真皮细胞外基质重建尿道的实验和临床研究

Tissue-engineering material for the replacement of urethral

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【作者】 刘流梁德江申鹏飞李迟王海吴天平

【Author】 LIU Liu *,LIANG Dejiang,SHEN Pengfei, et al. Department of Urology,Beijing Jishuitan Hospital,Beijing 100035,China

【机构】 北京积水潭医院泌尿外科湖南医科大学湘雅医院泌尿外科北京积水潭医院烧伤科

【摘要】 目的 寻求理想的尿道修复材料。 方法 将 2只犬真皮脱细胞处理后制成真皮细胞外基质框架 ;18只犬分为 2组 :异体真皮细胞外基质 (ECM )移植组 (实验组 ) 15只 ,异体真皮移植组(对照组 ) 3只。全麻下将尿道中段切除 5cm ,将同样长度真皮ECM或异体真皮缝成直径 0 .3cm管状替代缺损尿道 ,8F硅塑管留置 4周。实验组分别于术后 1、3、6、12、2 4周每次 3只取材行光镜、电镜及免疫组化检查。 结果 组织学显示 :1周时移植物边缘腔内面有尿路上皮 ,管壁可见少量肌束 ,6周时移植物区尿路上皮达 4~ 5层 ,肌层分布均匀。 2 4周后移植物已无法与宿主尿道辨别。对照组术后 8~ 10d移植物坏死出现尿瘘。在实验基础上用于临床 2例均获成功。 结论 ECM为理想的尿道修复材料。

【Abstract】 Objective To experiment the use of allodecellular skin extracellular matrix for the replacement of urethral. Methods Skin extracellular matrix was obtained from 2 dogs by decellularization process.18 experimental dogs were used and a 4 cm segment of urethral was resected in each.In the experimental group of 15 dogs,the resected urethral was replaced by the allo skin ECM.In the control group of 3 dogs,the resected urethral was replaced by allograft transplantation of untreated skin.The neourethral segment was studied with ecectronmicroscopy and immunohistochemical procedures. Results In the experiment animals,urothelial and monocytes could be seen in the ECM area and fully filled up the area after 6 weeks.The histological structure was not much different with a normal urethra.In the control group with allograft transplantation,rejection and necrosis occurred 8~10 days after the transplantation.On the basis of the experiment,skin ECM has been successfully used in clinical practice for 2 patients. Conclusions Alloskin ECM may be an ideal tissue engineering material for the replacement of urethral.

【关键词】 尿道细胞外基质移植
【Key words】 UrethraExtracellular matrixTransplantation
【基金】 北京市优秀青年知识分子培养基金资助 ( 99 10 2 3 )
  • 【文献出处】 中华泌尿外科杂志 ,Chinese Journal of Urology , 编辑部邮箱 ,2001年07期
  • 【分类号】R699.6
  • 【被引频次】24
  • 【下载频次】96
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