纳米仿生防粘连复合补片修复大鼠腹壁缺损中胶原合成功能的研究

目的评估纳米仿生、防粘连复合型疝补片修复腹壁疝的胶原蛋白合成功能的优劣，为临床提供实验依据。 方法选择成年SD雄性大鼠90只，随机分为3组：纳米仿生、防粘连复合型疝补片（nano-bionic and anti-adhesive compound hernia patch，NT）组，聚丙烯补片（polypropylene patch，PP）组及聚酯补片（polyester patch，PE）组，构建腹壁疝模型。根据分组将大小约3 cm× 2 cm的3组补片缝合于腹壁缺损处。术后观察大鼠一般情况，分别于术后4、6、8周处死大鼠各10只，大体观察腹腹壁手术区域胶原组织形成情况；剪取补片及其周围组织进行组织学观察，分析胶原蛋白表达情况，并进行Western bolt分析各组腹壁修复区域Ⅰ型胶原蛋白及Ⅲ型胶原蛋白表达量。 结果各组大鼠术后一般情况均良好，未出现死亡等不良事件；腹壁手术区域，NT组触感柔软，异物感较少，未见明显腹腔脏器突出，纤维组织生长情况良好；PP组触感较僵硬，皮下可见大量新生血管长入，异物感较重，纤维组织生长情况一般；PE组大鼠腹壁修复区触感僵硬，皮下可见较多新生血管长入，纤维组织生长较好。组织学观察：术后各个时间点，NT组修补效果优于PP、PE组，NT组Ⅰ型胶原表达更多，Ⅲ胶原表达更少，比例更加合理，纤维结构更加成熟稳定。组织蛋白含量：随着时间推移，术后各组Ⅰ型胶原蛋白随着时间进展逐步增加，而且NT组在各个时间点明显高于PP组及PE组，差异有统计学意义；术后6周及术后8周NT组的Ⅰ/Ⅲ型胶原蛋白比例基本保持在4∶1左右，较术后4周明显增加，而且在各个时间点上NT组均高于PP、PE组，差异有统计学意义。 结论在常规腹壁缺损无张力修补术过程中，NT补片在组织重构过程中比PP及PE补片更早形成成熟稳定的纤维结构，提供更加稳固的修复效果，适用于目前常规的腹壁疝修补，尤其是巨大腹壁缺损引起的腹壁疝。

Study of collagen synthesis function of repairing abdominal wall defects in rats by nano-bionic and anti-adhesive compound hernia patch

ObjectiveTo evaluate the advantages and disadvantages of nano-bionic and anti-adhesive compound hernia patch to repair the collagen synthesis function of the abdominal wall hernia. Methods90 adult male SD rats were randomly divided into 3 groups: NT group (nano-bionic and anti-adhesive compound hernia patch), PP group (polypropylene patch) and PE group (polyester patch), building a model of the abdominal wall hernia. The patch approximately 3 cm×2 cm in size was sutured to theabdominal wall defect. After the postoperative observation of rats, 10 rats were executed at 4, 6 and 8 weeks after surgery, respectively, and the formation of collagen tissue in the abdominal wall was observed. Shearing patch and its surrounding tissues for histologic observation and analysis of collagen protein expression, and Western bolt analysis of type I collagen and typeⅢ collagen expressionin abdominal wall repair area. ResultsThe postoperative general conditions of rats were good, and there were no adverse events such as death. In the area of abdominal wall surgery, the NT group had soft touch and less foreign body sensation, and no obvious abdominal organ protruding, and the fibrous tissue was growingwell. The feeling of the PP group was more rigid, and there were a large number of subcutaneous neovascularization. The abdominal wall repair area of the PE group was stiff, and the growth of the fibrous tissue was better. Histological observation: at each time point, the repair effect of NT group was better than that of PP group and PE group. NT group had more type I collagen expression, and less typeⅢ collagen expression. It had more reasonableratio of typeⅠ/Ⅲ collagen, more mature and stable fiber structure. Tissue protein: TypeⅠ collagen gradually increased over time in each group; At each time points, the NT group was obviously higher than that of PP group and PE group; At 6 weeks and 8 weeks after surgery, the ratio of typeⅠ/Ⅲ collagen in the NT group was about 4∶1, significantly increasingcompared with 4 weeks after the operation. ConclusionIn the process of routine tension-free repair of abdominal wall defect, the nano bionic, antiblocking compound hernia patch has earlier mature and stable fiber structurethan polypropylene patch and polyester patch, providing a more solid repair effect. It is applicable to the conventional abdominal wall hernia repair, especially in large abdominal wall defect caused by abdominal wall hernia.