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目的评价复合生物材料胶原蛋白/壳聚糖及聚乙烯醇/丝胶在膀胱扩大手术中的效果及可行性。方法雌性大鼠21只随机分为3组,即膀胱扩大手术组(实验组:修补材料为胶原蛋白/壳聚糖+聚乙烯醇/丝胶);膀胱部分切除组(对照组)和非手术组(平行对照组)。所有3组实验动物在术后7 d、21 d、42 d进行膀胱容量测定,并取材观察其形态学及组织学改变。结果接受膀胱扩大手术的大鼠,术后各时间点的膀胱容量均明显高于其他两组。大体检查见膀胱血管纹理清晰,修补部位与正常膀胱无明显分界,结石发生率为71.4%。镜下组织学检查发现:术后7 d时,支架外层大量炎症细胞浸润,组织结构无法分清。术后42 d时,支架内层上可见泌尿上皮呈多层排列,黏膜下层增厚明显,但平滑肌层相对稀疏且排列欠规则。结论复合生物支架胶原蛋白/壳聚糖+聚乙烯醇/丝胶能成功应用于大鼠膀胱扩大手术,但存在膀胱平滑肌层再生情况不佳、成石率较高的缺点,有待进一步研究改善。
Objective To evaluate the efficacy and feasibility of composite biomaterials collagen / chitosan and polyvinyl alcohol / sericin in bladder expansion surgery. Methods Twenty-one female rats were randomly divided into 3 groups: the bladder enlargement operation group (experimental group: repair material: collagen / chitosan + polyvinyl alcohol / sericin); partial bladder resection group (control group) Group (parallel control group). The bladder volume of all 3 experimental animals was measured at 7 days, 21 days and 42 days after surgery. The morphological and histological changes were observed. Results In bladder enlargement surgery, the bladder volume at each time point after operation was significantly higher than the other two groups. Gross examination revealed a clear vascular texture of the bladder, repair site and no significant delineation of the normal bladder, the incidence of stones was 71.4%. Microscopic examination showed that: after 7 days, a large number of inflammatory cells infiltrated the outer layer of the scaffold, the histological structure can not be distinguished. At 42 days after operation, the urothelium showed a multilayer arrangement on the inner layer of the scaffold, and the submucosal thickening was obvious. However, the smooth muscle layer was relatively sparse and arranged irregularly. Conclusion The composite bio-scaffold collagen / chitosan + PVA / sericin can be successfully applied to the expansion of the bladder in rats. However, there are some disadvantages such as poor regeneration of the bladder smooth muscle layer and high rate of stone formation, which need to be further studied and improved.