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目的:探讨盆底修复术中聚丙烯网片植入阴道后局部病理学变化。方法:采集自2004年5月至2011年12月于解放军总医院第一附属医院妇产科采用聚丙烯网片经阴道盆底修补治疗盆底功能障碍(Pelvic Floor Dysfunction,PFD)术后发生网片阴道暴露的样本18例,对局部暴露的网片进行切除,并进行病理学观察,总结阴道局部炎症反应的特点。结果:8例发生于手术后1个月内,组织反应以急性炎症反应为主,表现为粒细胞增多,后期在周围逐渐出现巨噬细胞,肉芽组织形成,毛细血管增生;9例1-6个月发生者转为慢性炎症反应,表现为成纤维细胞和淋巴细胞增多,6个月以上发生暴露1例,部分组织出现鳞状上皮增生。结论:聚丙烯网片植入阴道暴露局部组织分为急性反应期、慢性反应期、鳞状上皮增生期,6个月后可见纤维组织增生,胶原增加,炎细胞减少,10月后上皮结构基本同正常鳞状上皮。
Objective: To investigate the local pathological changes of polypropylene mesh implanted into the vagina during pelvic floor repair. Methods: From May 2004 to December 2011, pelvic floor dysfunction (Pelvic Floor Dysfunction, PFD) was performed by using vaginal pelvic floor polypropylene net in the Department of Obstetrics and Gynecology, the First Affiliated Hospital of PLA General Hospital. Vaginal exposure of the sample in 18 cases, the local exposure of the mesh removed, and pathological observation, summarizes the characteristics of the vaginal local inflammatory response. Results: Eight cases occurred within one month after operation. The tissue reaction was mainly acute inflammatory reaction, showing granulocyte increased. Macrophage, granulation tissue formation and capillary hyperplasia gradually appeared in the periphery. Nine cases 1-6 The occurrence of chronic inflammation in each month, manifested as an increase of fibroblasts and lymphocytes, more than 6 months of exposure occurred in 1 case, some organizations squamous epithelial hyperplasia. CONCLUSION: Local tissue with polypropylene mesh implanted vaginally is divided into acute reaction, chronic reaction, squamous epithelial hyperplasia. Six months later, fibrous tissue hyperplasia, collagen increased and inflammatory cells decreased. After 10 months, epithelial structure basically With normal squamous epithelium.