脱细胞真皮包裹PHEMA水凝胶义眼台的实验研究

目的:研究脱细胞真皮包裹的水凝胶义眼台复合物的制备方法,评价其生物学性能。方法:材料制备:用MMA和HEMA的聚合物单体加入NaCl成孔剂制备多孔水凝胶义眼台,750mL/L乙醇浸泡制备同种异体巩膜包裹物。动物实验:新西兰白兔32只,右眼球摘除术后,16只植入脱细胞真皮包裹的直径为12mm的水凝胶义眼台作为实验组,16只植入保存异体巩膜包裹的直径为12mm的水凝胶义眼台作为对照组,术后在不同时间点(2,4,8,12wk)取材作病理检查,比较不同包裹材料对义眼台血管化程度和义眼台植入并发症发生率影响的差别。结果:MMA和HEMA的聚合物单体体积膨胀率为1.2,孔隙率为72%,孔径大小为450～520μm,且多为通孔。不同材料包裹PHEMA多孔水凝胶义眼台植入兔眶腔术后,所有32眼无肉芽肿发生及义眼台排出。光镜结果显示纤维血管组织2wk时从植入物外周长入,4～8wk时孔隙内胶原纤维逐渐致密,12wk时完成纤维血管化,扫描电镜显示植入物孔隙内逐渐被纤维血管组织填充,2wk时纤维血管组织附壁生长,12wk时孔隙内被纤维血管组织充满且孔间相连。对各组植入物纤维血管化程度进行测量,结果进行多因素方差分析,实验组较对照组血管化速度快(P=0.01)。结论:PHEMA水凝胶义眼台和脱细胞真皮生物相容性好,是一种安全可靠的眶内植入物,符合临床应用的要求,具有潜在的实际应用价值。

Experimental study of the hydrogel orbital implant with acelluar dermal matrix wrapped

AIM:To study the preparation method of hydrogel orbital implant wrapped with acelluar dermal matrix and evaluation of its biological features.·METHODS: The orbital implant was made of copolymerized 2-hydroxyethyl methacryate(HEMA) with ethl methacrylate(MMA). The wrapped material was acelluar dermal matrix. Sevaral experiments were carried out to evaluate the properties of the implants such as light microscopy,SEM etc.There were two groups in the experiment,The first group was implanted with acelluar dermal matrix wrapped hydrogel orbital implants into the right orbit,the second group with homologous sclera. Biposies of implanted meterial were taken out on weeks 2,4,8 and 12 postoperation for histopathological and electron microscope examination. The results were com-pared betwen two groups.·RESULTS:MMA denaturative HEMA had good extensibility with its volume expansive rate of 1.2. The through-hole structure and the size of aperture was about 450-520μm. The hydrogel orbital implant wrapped with acelluar dermal matrix didn’t cause the occurrence of rejection. Fibrovascular tissue invaded the pores of the implant at 2 weeks and it went deeper from 4 to 8 weeks. Almost all implants were fully vascularized after 12 weeks.The speed of fibrovascular ingrowth in acelluar dermal matrix wrapped group was faster than that of homologous sclera.·CONCLUSION: The hydrogel orbital implant and acelluar dermal matrix wrapped material have steady quality,good histocompatibility and no reject reaction,they can be new materials instead of HA and homologous sclera.