【摘要】 目的探索组织工程方法在尿道修复中的应用。方法将12只雄兔作为实验对象,切除部分尿道的全周粘膜,长度分1cm以内(Ⅰ组)和2cm以上(Ⅱ组)两组,将制备完成的同种家兔膀胱粘膜下脱细胞筋膜用可吸收线,缝合到尿道缺损处,术后2周、6周分别处死一批实验对象,通过尿道造影,大体观察,修复段组织切片HE染色光镜研究和免疫组化等来研究修复段尿道的解剖和组织学变化。结果Ⅰ组仅1只(1/6)发生尿瘘,其余尿道造影显示尿道基本通畅；而Ⅱ组4只(4/6)发生狭窄(不伴尿瘘),1只(1/6)发生尿瘘；术后2周两组植入筋膜依然存在；术后6周时,尿道植入筋膜已降解,Ⅰ组的修复段尿道已全部被宿主自身粘膜所覆盖,粘膜光洁完整,管腔无明显狭小；Ⅱ组的修复段尿道中间苍白增厚,致密坚硬且管腔狭小。结论单纯脱细胞膀胱粘膜下筋膜能修复短距离兔尿道缺损,而对长距离缺损修复效果不理想。更多还原

【Abstract】 Objective To determine whether naturally derived collagen-based tissue substitute can using for urethral reconstruction.Methods The acellular collagen matrix was obtained and processed from rabbit bladder submucosa.The submucosa was microdissected and isolated from the muscular and serosal layers.A ventral urethral defect was created in 12 male rabbits which were divided into two groups according to length of defect(Ⅰ:＜1cm,Ⅱ:2～3cm).The acellular collagen matrix was trimmed and used to replace the urethral defect.Serial urethrography was performed preoperatively and postopera- tively at 2 and 6 weeks respectively.The animals were sacrificed 2 and 6 weeks postoperatively.The retrieved implants were analyzed grossly,histologically,and immunocytochemically.Results One fistula(1/6)was formed inⅠgroup.Serial urethrograrns confirmed the maintenance of a wide urethral caliber without any signs of strictures in other samples ofⅠgroup. One fistula(1/6)and four strictures(4/6)were observed inⅡgroup.Histological acellular collagen matrix was remained in 2 weeks postoperatively and was degraded in 6 weeks postoperatively.Gross examination at retrieval showed normal appearance of engineering tissue without any evidence of fibrosis inⅠgroup.Conclusion Accllular matrix derived from bladder submucosa can repair short length defect,while it is unpredictable to repair longer defect only by materials.更多还原