脱细胞真皮基质和聚丙烯补片修补大鼠腹壁疝的实验研究

摘要

Objective To study the value of porcine acellular dermal matrix(ADM) made by complex maceration and Marlex mesh as ventral hernia-repairing material. Methods ADM was made from the full thick skin of the back of swines by complex maceration. The male SD rats were randomly divided into three groups including ventral hernia group(n =7), ADM group(the ventral hernia repaired by ADM, n =28) and Marlex mesh group (the ventral hernia repaired by Marlex mesh group, n = 10). The occurrence of ventral hernia was observed on postoperative 1 week. Six rats were respectively selected from the Marlex group and ADM group and tension resistance at 5weeks after surgery was observed. Results The occurrence of ventral hernia in ADM group and Marlex mesh group was significantly lower than that of ventral hernia group(0.04%, 0.0%, 100.0%, P ＜ 0. 01 ) in postoperative 1week, but there was no difference between ADM group and Marlex mesh group ( P ＞ 0.05 ). Marlex had a significantly higher breaking strength than ADM[(417 ±44)N vs( 111 ±27)N,P ＜0.01]. But 5 weeks after surgery, the tension resistance of ADM-fascial interface was higher than that of the Marlex-fascial [( 103 ± 27 ) N vs(71 ± 19 ) N,P ＜ 0. 05]. Conclusion As a material of repairing ventral hernia, ADM prepared by the complex maceration may be superior to Marlex mesh.%目的 探讨复合消蚀法制备的脱细胞真皮基质(ADM)和聚丙烯补片(Marlex网)修补大鼠腹壁疝的应用价值.方法 用全厚猪皮制备ADM,选用SD雄性大鼠45只,完全随机分为腹壁疝组7只、Marlex网组10只和ADM组28只,观察3组术后1周时有无腹壁疝的发生,术后第5周Marlex网组和ADM组随机选取6只用于抗张力试验.结果 术后1周时,ADM组与Marlex网组腹壁疝发生率均明显低于腹壁疝组(分别为0.04%、0.00%、100.00%,P＜0.01),但ADM组与Marlex网组差异无统计学意义(P＞0.05).将单独ADM片与Marlex网行抗张力试验,Marlex网的抗张力远高于ADM[(417±44)N比(111±27)N,P＜0.01].但植入体内5周后,ADM-筋膜组织的抗张力高于Marlex-筋膜组织[(103±27)N比(71±19)N,P＜0.05].结论 复合消蚀法制备的ADM可能比聚丙烯补片更适合作为疝修补材料.