改性牛心包膜脱细胞基质应用于疝气补片的研究

发布时间：2018-02-10 12:28

本文关键词： 牛心包膜脱细胞基质材料辐照灭菌体外评价动物实验临床试验　出处：《暨南大学》2015年硕士论文　论文类型：学位论文

【摘要】：疝,是腹内脏器由正常位置通过腹壁上孔道或薄弱点向外形成的突出,临床上主要通过外科手术的方法,采取人工补片的方式修复腹壁薄弱或缺损点。本课题以牛心包膜作为原材料,经脱细胞、交联固定及辐照灭菌等工艺处理,制备出了一种新型的脱细胞基质疝修补材料。按照标准要求对该材料进行理化生评价,其中,脱细胞基质材料的拉伸强度1MPa,拉断伸长率10%,缝合强度5N,顶破强度5MPa,细胞去除率达到99%,无细胞毒性,DNA含量100ng/mg。钴-60γ射线25KGy辐照剂量下灭菌,能使水泡性口炎病毒、犬传染性肝炎病毒和柯萨奇病毒等指示病毒的去除数4logs。将24只新西兰白兔随机分为3组,构建腹壁缺损动物实验模型,分别用牛心包脱细胞基质材料、聚丙烯补片、膨化聚四氟乙烯补片进行修补,同时局部注射5滴金葡菌液,术后1M、3M观察创面感染情况及腹腔内粘连情况,并通过细菌培养、病理切片等方法评价三种补片置入动物体内后的耐受感染能力。结果显示:脱细胞基质材料在耐受感染的同时,具备有效的防脏器粘连的能力;聚丙烯补片耐受感染能力与脱细胞基质材料相同,但不能有效防止脏器粘连;膨化聚四氟乙烯补片具有一定的防粘连能力,但是耐受感染能力较差。脱细胞基质材料应用于疝修补手术具有一定的优势。牛心包脱细胞基质材料应用于青少年腹股沟疝外科治疗手术中,也取得了显著的临床效果。50例患者术后随访观察12~24个月,未出现伤口感染、戳孔疝、戳孔血肿、无慢性疼痛、异物感或疝复发。脱细胞基质材料应用于1例罕见巨大切口疝外科治疗手术中,患者伤口一期愈合,肠功能恢复良好,未复发。临床试验结果显示:脱细胞基质材料应用于腹壁疝外科手术中,能有效地降低术后并发症发生率及复发率,极大地提高患者的生活质量。
[Abstract]:Hernia is a protruding form of the abdominal viscera from its normal position through the upper hole or weakness of the abdominal wall. Clinically, it is mainly operated upon. In this paper, the bovine pericardium was used as the raw material, which was treated by acellular, crosslinking and sterilizing, etc. A new type of acellular stromal hernia repair material was prepared. The tensile strength of acellular matrix material is 1 MPA, elongation at break is 10%, suture strength is 5 N, breaking strength is 5 MPA, cell removal rate is 99%, DNA content is 100 ng / mg 路Co ~ (60) 纬 -ray irradiation dose is 25 KGy, the virus can be sterilized. 4 logs. 24 New Zealand white rabbits were randomly divided into 3 groups to construct experimental models of abdominal wall defect, using bovine pericardial acellular matrix material and polypropylene patch, respectively. The expanded PTFE patch was repaired, and 5 drops of staphylococcus aureus fluid were injected locally. The infection of wound and intraperitoneal adhesion were observed 1 M3 M after operation, and the bacteria were cultured. The results showed that the acellular matrix material had the ability of preventing visceral adhesion while withstanding infection. The ability of polypropylene patch to resist infection is the same as that of acellular matrix material, but it can not effectively prevent visceral adhesion. But the ability of resisting infection is poor. The acellular matrix material used in hernia repair has some advantages, and bovine pericardial acellular matrix material is used in the surgical treatment of juvenile inguinal hernia. There were no wound infection, hernia, hematoma, no chronic pain, no chronic pain, no chronic pain. Foreign body sensation or hernia recurrence. Acellular matrix material was used in the surgical treatment of a rare giant incisional hernia. The wound healed at the first stage and the intestinal function recovered well. The results of clinical trial showed that the application of acellular matrix material in abdominal hernia surgery can effectively reduce the incidence of postoperative complications and recurrence rate and greatly improve the quality of life of patients.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.2

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