摘要
目的评价人工生物膜修补狗尿道缺损的效果．为临床寻找理想的尿道成形替代材料奠定基础。方法以8只体重10～15妇、年龄6～8个月的雄性狗为研究对象。静脉全麻下，分别对上述狗行阴茎前端尿道全层剥离切断术，形成长约5cm的尿道缺损。接着用人工生物膜修补上述缺损。F10硅胶管作为尿道支架管。术后密切观察实验狗的排尿情况，并存2周～6个月期间取尿道标本，检查其修复情况。结果1只狗在术后11d将尿道支架管和人工生物膜咬脱，须行膀胱造瘘．病理检查显示其无尿道组织生长。4只狗在术后14～22d将尿道支架管咬脱，3只狗的尿道支架管在术后30-46d由人工拔除。后述的7只狗有6只排尿成线状、尿线较直；取尿道标本，大体上见尿道腔内面均形成一与正常尿道上皮层相连续的薄层结构；病理检查．其中1个标本取自术后16d尿道，见纤维素性渗出物覆盖，无存活的移行上皮细胞团。其余6个标本分别取自术后39d、48d、60d、73d、162d和181d的尿道，均显示有正常的尿道上皮结构。结论人工生物膜可作为修补尿道缺损的材料；为确保尿道缺损的顺利修复，尿道支架管至少保留2周；人工生物膜修复5cm长的尿道缺损需要超过1个月的时间。
Objective To evaluate the effects of biotype artificial membrane for repairing urethral defects in dogs. Methods Eight male young dogs were adopted in this study. A 5 cm urethral defect was induced in the eight dogs and repaired with biotype artificial membrane. A F10 silica gel tube was employed as postoperative urethral stent in all dogs. Micturition was observed daily and pathological observation was conducted to examine the regenerative segments of the urethra between 2 weeks and 6 months postoperatively. Results Urine could be drained through the urethral stent immediately after operation in all dogs. Only one dog had the urethral stent and artificial urethral membranes bitten out at 11 days after operation and this dog needed artifistulation. Pathological examination of this dog showed that no urethral tissue grew and substituted by connective tissue. Four dogs had urethral stent bitten out between 14 days and 22 days after operation. Other three dogs had their urethral stent drew out at one month or longer after operation. All the seven dogs could voluntary micturate after the re moval of urethral stent, four of which showed stream, the other three also showed satisfactory micturition with occasional dribbing. However, two of three recovered stream after urethral sounding. All the seven dogs had been conducted pathological examination. Two had urethral stent bitten out at 14 days after operation, of which one showed fibrinoid exudation covering the urethra and no survival transitional epithelial ceil mass when examined at 16 days after operation, while the other showed in tact urinary tract epithelia with mild scar tissue hyperplasia in the lamina propria when examined at 2 months after operation. The other five dogs all had retained urethral stent for more than 3 weeks and examined at 39 days, 48 days, 73 days, 162 days and 181 days postoperatively, respectively. Except focal ulcer formation in the urethra examined at 39 days after operation, the others showed normal urinary tract structure. Conclusions The hiotype artificial membrane is an ideal material to repair urethral defect. The urethral stent should be retained for at least two weeks to ensure the repairing of urethra. It takes more than one month to repair the 5 cm urethral defect.
出处
《中华小儿外科杂志》
CSCD
北大核心
2008年第9期561-564,共4页
Chinese Journal of Pediatric Surgery
关键词
生物膜
尿道
动物
实验
Biofilms： Urethra
Animals,laboratory
