热传导法构建大鼠宫腔粘连模型的研究

目的 采用热传导法损伤大鼠子宫内膜,建立稳定的大鼠宫腔粘连模型.方法 将48只雌性SD大鼠随机分为4组,每组12只.假手术组:仅开腹穿刺左侧子宫,无热损伤;热损伤10 s组、15 s组和20 s组分别采用100℃热水导管损伤大鼠左侧宫腔10 s、15 s和20 s.分别于造模后3、7、14和21 d每组大鼠处死3只,收集双侧子宫进行病理学鉴定,采用HE染色观察各组大鼠子宫内膜形态变化及腺体数量,Masson染色分析各组子宫内膜纤维化程度.结果 与假手术组相比,热损伤10 s组造模后14 d即可达到自我修复,宫腔形态基本恢复,有大量腺体新生;热损伤15 s组造模后14 d宫腔形态狭小,肌层完整,大量胶原纤维聚集形成致密粘连,较大程度的符合人类宫腔粘连的病理表现;热损伤20 s组造模后7、14和21 d宫腔已完全封闭,肌层结构紊乱,未见腺体结构,内膜过度受损.与假手术组比较,热损伤10 s组、15 s组和20 s组子宫内膜腺体数目依次降低,而子宫内膜纤维化面积比依次增高,差异均具有统计学意义(P<0.05).结论 以100℃的热水导管损伤大鼠宫腔15 s,造模14 d后可成功构建稳定的大鼠宫腔粘连模型.

Establishment of Rat Models of Intrauterine Adhesions by Radiant Heat Method

Objective To establish stable rat models of intrauterine adhesions by radiant heat method to injure rats' endometrium. Methods A total of 48 female SD rats were randomly divided into four groups ( n=12 rats for each group) . Sham operation group was treated with laparotomy to puncture the left uterus only without thermal damage;ther-mal damage 10 s, 15 s and 20 s groups were treated with 100℃ hot water catheter to damage left uterine cavity for 10 s, 15 s and 20 s respectively. At the 3rd, 7th, 14th and 21st d after models establishment, 3 rats in each group were sacrificed to collect the bilateral uteri for pathological assessment. Hematoxylin and eosin ( HE) staining method was used to ob-serve changes of endometrial morphology and glandular organ number, and Masson staining method was used to analyze endometrial fibering degree. Results Compared with those in sham operation group, at 14th d after models establish-ment, the thermal damage 10 s group achieved self repair, and the uterine cavity shape recovered basically, and there were a lot of new glandular organs;at 14th d after models establishment, the thermal damage 15 s group showed that nar-row uterine cavity, complete muscular layer, and a large number of collagen fibers were clustered and formed dense adhe-sion, which was in good accordance with the pathological manifestation of human intrauterine adhesions;at 7th, 14th and 21st d after models establishment, thermal damage 20 s group showed that uterine cavity was completely closed, muscular layer was disorganized, the glandular structure was not seen, and intima was over damaged. Compared with those in sham operation group, in thermal damage 10 s, 15 s and 20 s groups, numbers of endometrial glands were decreased in turn, while endometrial fibrosis area rates were increased in turn, and the differences were statistically significant (P<0. 05). Conclusion Stable intrauterine adhesions rat models can be successfully established 14 d later by using the catheter filled with 100℃ water to injury the endometrium for 15 s.