异种(牛)脱细胞真皮基质-游离空肠复合体构建实验研究

目的 研究异种(牛)脱细胞真皮基质-游离空肠复合体的构建技术,以期解决游离空肠移植重建长段气管术后肠腺分泌的问题。 方法 选择10只杂种犬,制备去上皮游离空肠段,将剪成合适大小的异种(牛)脱细胞真皮基质覆盖于游离空肠基底膜表面,并用覆膜镍钛合金支架支撑固定,将构建好的复合体移至腹膜外与腹部皮肤之间,分别于术后7 d、14 d、1个月、3个月和6个月后取出,查看复合体的生长情况。 结果 10只实验犬中,有1只因肠粘连和伤口感染死亡而未能完成实验,余9只实验犬术后存活良好。术后7 d、14 d肉眼观察和病理检查,在游离空肠内表面均见有异种(牛)脱细胞真皮基质成分,表面黏膜层可见部分鳞状上皮化生;术后1个月、3个月、6个月肉眼和病理检查均未再发现异种(牛)脱细胞真皮基质成分,游离空肠内表面几乎全部化生为复层鳞状上皮。 结论 合适大小的异种(牛)脱细胞真皮基质覆盖在去上皮游离空肠内表面,可以促进游离空肠内表面的鳞状上皮化生,抑制肠腺分泌。覆膜镍钛记忆合金支架有一定的弹性,可以很好的对异种(牛)脱细胞真皮基质-去上皮游离空肠复合体起到支撑固定作用。

Experimental study on the construction of heterogeneous decellularized dermal matrix-free jejunal complex

Objective To study the construction of heterogeneous decellularized dermal matrix-free jejunal complex,in order to solve problem of intestinal secretion after the reconstruction of long-segment trachea with free jejunal graft. Methods A total of 10 adult mongrel dogs were involved.We cut the heterogeneous decellularized dermal matrix into suitable diameter,put it on the inner face of the jejunum whose mucous layer had been removed,and then used the Shape-memory Titanium-nickel Alloy stand to support it.On day 7,14,30,90 and 180,we harvested the complex to observe the growth of epithelium with microscope.Results Of all 10 dogs,one dog died of intestinal adhesion and wound infection.The other 9 dogs lived to the end of the experiment.On day 7 and 14,we detected heterogeneous de-cellularized dermal matrix components,and part of free jejunal inner surface was squamous metaplasia.On day 30,90 and 180,we did not detect any heterogeneous decellularized dermal matrix components,and almost all free jejunal inner surface was squamous metaplasia.Conclusion Heterogeneous decellularized dermal matrix with appropriate size could survive on the inner surface of the jejunum whose mucous layer had been removed and promote squamous metaplasia, thus inhibiting intestinal secretion.The Shape-memory Titanium-nickel Alloy stand could serve as a good support.