【作者】 田兆菊；

【导师】 李建基； 王春璈；

【作者基本信息】 山东农业大学 ， 临床兽医学， 2004， 硕士

【摘要】 为了克服传统缝线缝合组织加重瘢痕形成的不足,本试验用WAB生物粘合剂(WAB Biological Adhesive)代替缝线,应用于犬耳整形术及雄犬的尿道吻合术中。试验分为两大部分:试验一(WAB生物粘合剂在犬耳整形术中的应用试验)、试验二(WAB生物粘合剂在雄犬尿道吻合术中的应用试验)。试验一 WAB生物粘合剂在犬耳整形术中的应用试验 分为试验组(WAB生物粘合剂组 )和对照组(丝线缝合组)两组。对照组采用传统丝线对切除耳廓后的断缘进行锁边缝合;试验组用WAB生物粘合剂代替丝线应用于耳断缘背、腹侧皮肤的粘合,两组的其它条件相同。术后定期观测局部愈合情况、局部组织切片变化和瘢痕组织中羟脯氨酸(Hydroxyproline,Hyp)的含量,从瘢痕形成、发展的角度以及瘢痕形成量的多少来判断犬耳皮肤切口的愈合情况,明确WAB生物粘合剂对皮肤切口的粘合效果。结果如下:试验组组织切片中可见:术后1-5天,炎性反应由重变轻,视野中可见浆液、纤维素渗出及组织坏死物、中性粒细胞、巨噬细胞等;7天,炎性细胞逐渐消失;14-21天肉芽组织逐渐成熟,胞外基质排列紊乱,胶原纤维增多;3个月时,瘢痕组织中的胞外基质排列基本出现一定的方向性,呈波浪状;从6个月开始,瘢痕组织的胶原平行排列。羟脯氨酸含量的测定结果表明:术后14天时明显增多, 3个月时含量最高,达到23.63㎎/g,以后迅速下降,6-12个月时,含量基本稳定(16.61-17.11㎎/g)。对照组组织切片中可见,1-5天炎性细胞明显多于试验组,胶原纤维在3个月时多于试验组,胞外基质在9个月时出现一定的方向性。羟脯氨酸含量的测定结果表明:术后14天时,Hyp含量明显增多,3个月时亦达到最高,为28.56㎎/g ,以后逐渐下降,9-12月时,含量基本稳定,为17.08-17.33㎎/g。对照组与试验组相比较,羟脯氨酸含量1-14天,差异不显著(P>0.05),21天-3个月时差异显著<WP=8>(0.01<P<0.05),6个月时差异极显著(P<0.01),9、12个月差异不显著(P>0.05)。试验二 WAB生物粘合剂在雄犬尿道吻合术中的应用试验 分为试验组(WAB生物粘合剂粘合组 )和对照组(肠衣线缝合组)两组。术前两组动物的尿道内插入适当口径的导尿管并固定确实。对照组采用肠衣线缝合尿道粘膜及尿道海绵体;试验组用WAB生物粘合剂粘合尿道粘膜及尿道海绵体,两组其它条件相同。术后加强护理,定期测量尿道内通过导尿管口径的大小、观测尿道愈合情况、局部组织切片变化及瘢痕中羟脯氨酸的含量,从尿道的管腔大小、瘢痕组织的形成、发展过程及瘢痕形成量的多少来判断尿道的愈合情况,推断WAB生物粘合剂与肠衣线对尿道吻合的不同,明确WAB生物粘合剂对尿道组织的粘合效果。结果如下:试验组组织切片可见:术后1-14天,视野中不同程度的见到浆液、纤维素渗出液、组织坏死物、中性粒细胞及巨噬细胞等;14-21天肉芽组织逐渐成熟,胶原纤维增多,胞外基质排列紊乱;3个月时,胞外基质排列出现一定的方向性;从6个月开始,胶原纤维平行排列。羟脯氨酸含量的测定结果表明:Hyp含量术后14天明显增多,3个月时含量最高,达到28.18㎎/g,以后迅速下降,6-12个月时,含量基本稳定(19.16-19.35 ㎎/g)。对照组组织切片可见,1-7天,炎性细胞明显多于试验组,3个月时,胶原纤维较多,9个月时,胶原纤维呈平行排列。羟脯氨酸含量的测定结果表明:Hyp含量14天时明显增多,3个月时达到高峰,为32.95㎎/g,以后下降,9-12月基本稳定(19.94-20.15㎎/g)。对照组与试验组相比较,羟脯氨酸含量1-21天差异不显著(P>0.05),1-3个月差异显著(0.01<P<0.05),6个月时差异极显著(P<0.01),9、12个月时差异不显著(P>0.05)。 结论:WAB生物粘合剂具有促进伤口愈合、减少瘢痕形成,加速瘢痕成熟、稳定的作用;WAB生物粘合剂代替传统缝线用于犬耳整形术和雄犬尿道吻合术中,具有提高局部美观程度,预防尿道吻合口狭窄的作用。更多还原

【Abstract】 Conventional suture techniques for plastic surgery on canine ears and for urethrotomy on male canines resulted in heavy scar. To overcome the aforementioned draw-backs, WAB biological adhesive was used in the operation. The experiments contained two parts: experiment one and experiment two. ExperimentⅠ: Application of WAB biological adhesive in plastic surgery on canine ears This experiment consisted of both the test group using WAB biological adhesive and the control group using conventional suture. Conventional lockstitch with silk thread was used to suture the dorsal and abdominal skins of incision on canine ears in the control group, and the WAB biological adhesive was used to adhere the skin incinsions on the canine ears in the test group. During the wound healing, periodical clinic observations, pathological studies and examination of hydroxyproline (Hyp) content were done. The results showed as follows: In the test group, from the pathological studies, the inflammation of the incision were becoming lighter and lighter from 1st to 5th day after the operation, and there were serous and fibroid exudate, tissue necrosis, neutrophil, macrophage and so on; then on the 7th day, inflammatory cells gradually dissappered; from the 14th to the 21st day, there were mature <WP=10>granulation tissue, the extracellular matrix with disordering arrangement and the increasing collange fiber. On the 3rd month, the arrangement of the extracellular matrix was basically in direction like waves, and arranged parallelly after the 6th month. From the determination of Hyp content, the Hyp content began to increase on the 14th day, reached the maximum on the 3rd month(23.63 mg/g), then decreaed sharply from 3rd to 6th month , tended to stabilize from the 6th to the 12th month(16.61-17.11㎎/g). In the control group, there were more inflammatory cells from the 1st to the 5th day, more collagen fibers on the 3rd month than those in the test group. On the 9th month, the extracellular matrix was in direction. The content of Hyp also increased on the 14th day, came up to its maximum on the 3rd month (28.56 mg/g), decreased gradually and maintained a stable level from the 9th to the 12th month (17.08-17.33 mg/g). As compared with ones in the test group, the Hyp content in the control group was no different from the 1st to the 5th day (P>0.05), obviously higher from the 21st day to the 3rd month (0.01<P<0.05), sharply striking higher on the 6th month (P<0.01), and had no different from the 9th to the 12th month (P>0.05). Experiment Ⅱ:Application of WAB biological adhesive in urethrorrhaphy of male canines with urethrotomy This experiment consisted of the test group using WAB biological adhesive and the control group using catgut suture. Appropriate urethral catheters were inserted into the urethra before the operation and stabilized inside the prepuce. The catgut suture was used to suture the urethral mucosa and corpus cavernosum urethrae in control group, while WAB biological adhesive was used to adhere the urethral mucosa and corpus cavernosum urethrae. Besides these, the two groups had the same condition. After the operation, the caliber of the urethral catheter through the urethra, the incision healing and pathological slices were periodically observed and the Hyp content in the scar was measured. The results were as follows: In the test group, in the tissue slice, there appeared serous and fibroid exudate, tissue <WP=11>necrosis, neutrophil, macrophage and so on from the 1st to the 14th day, the mature granulation tissue, the extracellular matrix with disordering arrangement and the increasing collagen fiber from the 14th to the 21st day. Then on the 3rd month, the arrangement of the extracellular matrix was basically in a certain direction, and arranged parallelly after the 6th month. The Hyp content increased obviously on the 14th day, reached the maximum on the 3rd month (28.18 mg/g), then decreased sharply and maintained stable level (19.16-19.35mg/g). In the control group, in the tissue slice, there were more inflamm更多还原