膀胱无细胞基质移植物重建同种异体兔膀胱的研究

目的探讨膀胱无细胞基质移植物（BAMG）重建同种异体兔膀胱的效果。方法制备兔BAMG,用一半膀胱大小的BAMG对已行半个膀胱切除的25只同种异体兔做原位移植。8周时测定重建膀胱的容量、压力和顺应性,行膀胱造影;于术后1,2,4,8,12和16周,分别行重建膀胱的光镜和电镜观察。结果同种异体兔膀胱重建术后,肉眼可见BAMG结构上逐渐再生完全。术前与术后8周膀胱最大流出压（Pves,mas）、膀胱最大容量（VOlmax）和顺应性（VOlmax／Pves,mas）比较,差异均无统计学意义（P均〉0．05）。重建膀胱X线造影显示膀胱形态恢复正常。膀胱重建后1周时,在原膀胱和BAMG的交界处有上皮细胞、炎症细胞和毛细血管出现;2周时,BAMG有平滑肌和多层上皮细胞形成;4周后,在BAMG内可见短小的神经,各种成分以BAMG为支架继续再生;16周时,移植的无细胞基质与原膀胱在组织学上无区别。结论应用BAMG重建同种异体兔膀胱后,其结构上和功能上的再牛是以BAMG为支架逐步完成的。

The dynamic effects of allogenic transplantations with the bladder acellular matrix grafts of rabbits

OBJECTIVE: To study the dynamic effects of allogenic transplantations with the bladder acellular matrix grafts (BAMG) of rabbits. METHODS: Hemi-cystectomies were performed in 25 rabbits, and the defects were repaired with BAMG about half bladder size. The rabbits underwent postoperative assessment of bladder function at 8 weeks, including cystometry, vesical volume, vesical compliance and cystography. The allografts were observed by light microscope and electron microscope at 1, 2, 4, 8, 12, 16 weeks after surgery. RESULTS: Macroscopic observation revealed that BAMG regenerated gradually. All urodynamic results of 8 weeks after surgery were not different statistically as compared with these of preoperation (P > 0.05). Cystography revealed that the morphous of bladder was recovered. Epithelialization and neovascularity occurred accompanied by infiltration of inflammatory cell at 1 week. Smooth muscle cell and stratified epithelium regenerated 2 weeks after grafting. Neural elements formed around smooth muscle bundles as early as 4 weeks. Each component regenerated on the frame of BAMG sequentially. After 16 weeks, it was difficult to delineate the junction between the host bladder and BAMG by histology. CONCLUSION: After allogenic transplantation with rabbits' BAMG, the constitution and function of the allografts regenerate completely and gradually on the frame of BAMG.