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目的探讨应用自体皮下诱导生成的管状肉芽组织重建兔全周尿道的可行性。方法 18只雄性兔分为实验组与对照组,每组9只,全周游离并切除1.0 cm前尿道,实验组应用自体皮下诱导生成的管状肉芽组织原位修复尿道缺损,对照组行单纯端端吻合。术后1、2及6个月行尿道造影、大体观察、组织学检测及Western blotting检测,动态评估新尿道通畅度及组织再生。结果组织学及透射电镜检测显示,新生管状肉芽组织富含胶原纤维及肌成纤维细胞。实验组术后尿道腔保持通畅,对照组则发生进行性狭窄。实验组术后移植物表面逐渐覆盖完整的尿路上皮层,上皮下可见排列日趋致密规则的新生平滑肌束。Western blotting示实验组随术后时间延长,移植物细胞广谱角蛋白AE1/AE3及α-平滑肌肌动蛋白表达量均逐渐增加,术后6个月其表达量接近正常尿道。结论自体皮下诱导生成的管状肉芽组织可成功修复兔1.0 cm长前尿道缺损。
Objective To investigate the feasibility of reconstructing rabbit periurethral urethra with tubular granulation tissue generated by subcutaneous self-induction. Methods Eighteen male rabbits were randomly divided into experimental group and control group, with 9 rats in each group. All rabbits were detached and 1.0 cm anterior urethra was excised. The experimental group was treated with autologous subcutaneous tissue-formed tubular granulation tissue to repair urethral defect. End anastomosis. Urethral angiography, gross observation, histological examination and Western blotting were performed at 1, 2 and 6 months after operation to evaluate the new urethral patency and tissue regeneration dynamically. Results Histology and transmission electron microscopy showed that nascent tubular granulation tissue is rich in collagen fibers and myofibroblasts. The postoperative urethral cavity in the experimental group remained unobstructed while the control group developed progressive stenosis. In the experimental group, the surface of the graft gradually covered the intact urinary tract epithelium, and new smooth muscle bundles arranged in an increasingly dense manner were observed under the skin. Western blotting showed that the expression of the broad-spectrum keratin AE1 / AE3 and a-smooth muscle actin increased gradually in the experimental group as time went after the operation, and the expression was close to the normal urethra 6 months after the operation. Conclusion The tubular granulation tissue induced by autologous subcutaneous injection can successfully repair the anterior urethral defect of 1.0 cm in length.