罗新 张仙 范瑾 帅翰林 蒋学风 李瑞满
【摘要】 目的: 观察非感染状态下医用聚丙烯网片在动物体内1个月至6个月生物相容性的病理缩变及超微结构变化。方法: 在6只清洁级新西兰家兔腹部皮下植入10mm×40mm的医用聚丙烯网片各10条，共计60条。按随机数字表分为3组，每组两只实验家兔，分别于术后 30天（A组）、90天（B组）、180天（C组）取出网片连同周围组织、以家兔假手术部位的皮肤及皮下组织作自身对照（D组）。用游标卡尺测量植入前网片长宽值以及植入后不同时间手术取出网片-组织长宽值，计算面积比值算出缩变率。光镜下观察炎症反应、纤维囊形成情况，参照中华人民共和国国家标准GB/T16886.6-1997Ⅰ-Ⅳ分级，评价植入网片的生物相容性。扫描电镜下观察网片与机体组织的融合情况，所有计量资料采用方差分析，检验水准P=0.05。结果:所有家兔均未见感染、侵蚀、暴露。A组、B组、C组网片缩变率分别为4.5%±1.4%、5%±2%、6.7%±2.2%，C组网片缩变率最大，与A组、B组相比差别有统计学意义（P＜0.05）；A组与B组相比差别无统计学意义（P>0.05）。A组、B组、C组、D组炎症反应分别为Ⅱ级、<Ⅰ级、<Ⅰ级、<Ⅰ级，纤维囊形成级别分别为Ⅱ级、<Ⅰ级、<Ⅰ级、<Ⅰ级,各组均未见组织萎缩及伊红变性。扫描电镜下各组均见结缔组织包绕网丝，纤维囊厚度随时间延长而变薄，各组网丝表面未见破裂、磨损。结论:医用聚丙烯网片缩变率随时间延长而增大；医用聚丙烯网片在一定时期内可能具有较好的生物相容性。
Pathological and ultra-structural biocompatibility of polypropylene mesh in a non-infected rabbit modle
LUO Xin, ZHANG Xian，FAN Jin, SHUAI Han-lin, JIANG Xue-feng, LI Rui-man
（Department of gynecology and obstetrics, the First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province，510630，China.)
【Abstract】 Objective to evaluate the biocompatibility and shrinkage of polypropylene mesh implanted in a non-infected rabbit model after 30 days,90 days and 180 days, respectively. Method 10 pieces of polypropylene meshes sized 10mm×40mm were implanted on subcutaneous tissue of 6 New Zealand white rabbits respectively. Mesh-tissues and subcutaneous tissue-muscle were explanted after 30 days，90 days and 180 days (2 rabbits per group). Shrinkage of all samples were recorded and all samples were evaluated for inflammatory response and fiber capsule formation by light microscopy. Each of these two categories was graded on a scale of Ⅰ-Ⅳ according to GB/T16886.6-1997. All samples were also evaluated for integration by scanning electron microscope. All measurement data were analyzed using Analysis of Variance with P<0.05 as significant. Results There were no signs of infection，erosion and exposure observed on the surgical site in all the rabbits. Shrinkage of the meshes in group A ，group B and group C was 4.5%±1.4%, 5.0%±2.0%, 6.7%±2.2%, respectively. The mesh shrank to a greater extent with time, while group C shrank greatest, with significant difference comparing to group A and B. There was no statistically significant difference between group A and B. Pathological study showed that both inflammation and fiber capsule formation were class II in group A and < class I in Group B, Group C and Group D. There were no obvious esophylic and atrophic changes in the muscular tissue in all the groups. Ultra-structural study showed that connective tissue was well integrated into the mesh and fiber capsule was becoming thinner with time. No fracture occurred in the mesh fiber. Conclusion Polypropylene mesh shrank to a greater extent with time and presented excellent biocompatibility in the rabbit model.
【keywords】 polypropylene mesh，biocompatibility ，scanning electron microscope，shrinkage