疝修复用纺织基补片的结构与性能研究

发布时间：2019-03-20 14:38

【摘要】：人体腹壁作为一种动态系统，可以抵抗腹腔内的持续压力和突变压力，补片植入人体后，在腹壁正常活动下将持续承受一定压力，并被反复弯折。因此，作为腹壁增强材料，补片应能在动态压力下具有足够的强度及力学稳定性。聚丙烯（polypropylene，PP）是一种广泛应用于疝修复手术中的合成材料，PP补片具有丰富的纺织结构、规格和形态，其不同的物理力学性能，与各种术后并发症密切相关。为此纺织基补片的结构与性能的内在关系值得深入分析与研究，目前，，国内外尚鲜有详细报道。本研究将对9种临床常用的进口补片、1种临床用的国产补片和1种自主设计的国产补片的原料、结构和性能进行测试、分析与评价。具体研究内容包括三部分，一是对国内外PP单丝原料进行线密度和力学性能测试，分析单丝性能对补片结构和性能的影响。二是对11种国内外补片进行结构分析测试，测试项目包括补片的织造特征、几何特征和表面形态等三大类，对测试结果进行评价，并就与补片临床愈合密切相关的孔隙率指标进行了深入探讨。三是选取3种结构相似的国内外补片进行力学性能测试及物理性能分析测试，研究补片结构对其力学性能特别是疲劳性能的影响。研究结果表明，进口PP单丝的强度略高于国产PP，但国产PP单丝细度小，更适合编织轻质补片；不同结构和单丝直径的补片样品，其横纵向密度各有差异，相比起纺织结构间的差异，补片编织原料单丝的粗细对补片的几何特征影响更大；影响补片强力的主要因素是材料结晶度、补片几何结构、微观结构和裁剪方向，且几个因素之间存在相互对应的影响关系；PP补片经过反复拉伸后受到明显的疲劳损伤，要根据不同强力和伸长要求，相应变换补片裁剪和放置方向；PP补片的正反面刚度有差异，临床使用时需注意方向性。针对PP补片在临床中使用时易与内脏发生粘连的情况，在进行国内外补片性能分析测试的基础上，综合比较各类产品，选择对自主设计的补片进行进一步改进。尝试以胶原溶液为原料，采用静电纺技术，初步探索纺织基抗粘连复合补片。综上所述，课题完成了对PP补片样品较为全面的性能测试与评价，分析了补片结构对性能的影响，并对防粘连复合补片的设计和制备进行了初步探索。研究结果对于改善国产PP产品的设计和制备具有一定的参考价值。
[Abstract]:As a dynamic system, the abdominal wall of the human body can resist the continuous pressure and abrupt pressure in the abdominal cavity. After the patch is implanted into the human body, it will continue to bear a certain pressure under the normal activity of the abdominal wall, and will be bent over and over again. Therefore, as a web wall reinforcement material, the patch should have sufficient strength and mechanical stability under dynamic pressure. Polypropylene (polypropylene,PP) is a synthetic material widely used in hernia repair surgery. PP patch has rich textile structure, specification and shape, and its different physical and mechanical properties are closely related to various postoperative complications. Therefore, the internal relationship between structure and properties of textile base patch is worthy of further analysis and study. At present, there are few detailed reports at home and abroad. In this study, the raw materials, structures and properties of 9 kinds of imported patches, 1 domestic patch for clinical use and 1 kind of homemade patch designed by ourselves were tested, analyzed and evaluated. The main contents include three parts: one is to test the linear density and mechanical properties of PP monofilament materials at home and abroad, and analyze the influence of monofilament properties on the structure and properties of patch. Secondly, the structure analysis and test of 11 kinds of patches at home and abroad are carried out. The testing items include weaving characteristics, geometric features and surface morphology of the patches, and the test results are evaluated. The porosity index which is closely related to the clinical healing of the patch is also discussed in this paper. Thirdly, the mechanical properties and physical properties of three kinds of domestic and foreign patches with similar structures are tested, and the effects of the patch structures on the mechanical properties, especially the fatigue properties, are studied. The results show that the strength of imported PP monofilament is slightly higher than that of domestic PP, but the fineness of domestic PP monofilament is small, so it is more suitable for knitting lightweight patch. The transverse and longitudinal densities of patch samples with different structure and monofilament diameter are different. Compared with the difference between textile structures, the thickness of monofilament has greater influence on the geometric characteristics of patch. The main factors affecting the strength of the patch are the crystallinity of the material, the geometric structure of the patch, the microstructure and the cutting direction, and there is a corresponding influence relationship among the several factors. After repeated stretching, PP patch is obviously damaged by fatigue, so it is necessary to change the direction of cutting and placing of patch according to different strength and elongation requirements, and the stiffness of PP patch is different, so it is necessary to pay attention to direction in clinical use. In view of the adhesion between PP patch and viscera when it is used in clinic, based on the analysis and test of patch performance at home and abroad, various products are compared synthetically, and the self-designed patch is chosen to be further improved. Using collagen solution as raw material and electrospinning technology, the textile-based anti-adhesion composite patch was preliminarily explored. In conclusion, we have completed the comprehensive performance test and evaluation of the PP patch sample, analyzed the influence of the patch structure on the performance, and made a preliminary exploration on the design and preparation of the anti-adhesion composite patch. The research results have certain reference value for improving the design and preparation of domestic PP products.
【学位授予单位】：东华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.2

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