中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (34): 5116-5121.doi: 10.3969/j.issn.2095-4344.2016.34.016

• 膜生物材料 membrane biomaterials • 上一篇    下一篇

Gynemesh聚丙烯补片在盆底重建中的应用效果

杨 岚1，王 娟1，徐兰兰1，王丽峰1，李艳芳2   

  1. 1广东医学院附属廉江市人民医院、廉江市人民医院，广东省廉江市  524400；       2中山大学附属肿瘤医院、中山大学肿瘤防治中心、华南肿瘤学国家重点实验室，广东省广州市  510060
  • 收稿日期:2016-06-09 出版日期:2016-08-19 发布日期:2016-08-19
  • 通讯作者: 李艳芳，博士，硕士生导师，主任医师，中山大学附属肿瘤医院、 中山大学肿瘤防治中心、华南肿瘤学国家重点实验室，广东省广州市 510060
  • 作者简介:杨岚，1973年生，广东省廉江市人，副主任医师，主要从事妇科肿瘤及内分泌研究。
  • 基金资助:
    中山大学附属肿瘤医院科研基金资助项目(201411)

Pelvic floor reconstruction using Gynemesh

Yang Lan1, Wang Juan1, Xu Lan-lan1, Wang Li-feng1, Li Yan-fang2   

  1. 1Lianjiang People’s Hospital of Guangdong Medical University, Lianjiang 524400, Guangdong Province, China; 2State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
  • Received:2016-06-09 Online:2016-08-19 Published:2016-08-19
  • Contact: Li Yan-fang, M.D., Master’s supervisor, Chief physician, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
  • About author:Yang Lan, Associate chief physician, Lianjiang People’s Hospital of Guangdong Medical University, Lianjiang 524400, Guangdong Province, China
  • Supported by:
    the Scientific Research Fund in the Sun Yat-sen University Cancer Center, No. 201411

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被引次数

1

摘要：

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文题释义：
Gynemesh聚丙烯补片：是单丝聚丙烯编织而成的补片样结构，经过加工后能够形成定型的平坦形状，具有较强的抗张力强度、较小的异物反应及良好的生物相容性，置入机体后能够迅速被纤维组织浸润。同时其化学性能相对稳定，具备较强的耐酸耐碱性，并且该材料制备时相对比较简单，材料更加容易获得，是盆底重建的理想材料。
全盆底重建：是以修复各处缺陷恢复正常解剖，恢复盆腔正常结构与功能，并且通过小切口导入网带或网片的微创手术。对无病变或已萎缩而无辜的脱垂子宫可进行保留，重点对盆底松弛、延长的韧带组织进行重建强固，以增强盆底的支持力度，恢复器官原有的解剖位置。

背景：Gynemesh聚丙烯补片由单丝聚丙烯编织而成，经过加工后能形成定型的平坦形状，具有较强的抗张力强度、较小的异物反应及良好的生物相容性。
目的：分析Gynemesh聚丙烯补片在盆底重建中的应用效果。
方法：采用化学液相还原方法制备Gynemesh聚丙烯补片，进行厚度、断裂伸长率、抗拉强度及弹性模量检测及组织学观察。在8只雌性新西兰大白兔阴道放置气囊，模拟盆底功能障碍模型，随机分为2组，实验组采用Gynemesh聚丙烯补片进行盆底重建，对照组进行阴道前后壁修复及全子宫切除。术后30 d，对比两组PFDI-20、PFIQ-7评分。
结果与结论：①Gynemesh聚丙烯补片厚度为(0.37±0.14) mm、断裂伸长率为(25.35±2.68)%、抗拉强度为(7.69±1.17) MPa、弹性模量为(0.007±0.008) GPa；光镜下观察显示，Gynemesh聚丙烯补片有大量淡红色胶原纤维且排列整齐，无蓝色染核物、无细胞残留；扫描电镜观察显示，Gynemesh聚丙烯补片上未见细胞残留且纤维保存完好，排列紧密；②实验组补片未出现侵蚀反应，术后30 d取出时补片完整，未在体内发生降解。实验组术后并发症发生率低于对照组(P < 0.05)；③结果表明：Gynemesh聚丙烯补片具备良好的生物力学性能，可促进盆底功能恢复。

ORCID: 0000-0001-7746-8734(杨岚)

关键词: 生物材料, 材料相容性, 盆底重建, Gynemesh聚丙烯补片, 手术效果, 传统手术

Abstract:

BACKGROUND: Gynemesh is a polypropylene fabric woven by monofilament polypropylene shaped into a flat form, with a strong tensile strength, small foreign body reaction and good biocompatibility.
OBJECTIVE: To investigate the effect of Gynemesh on pelvic floor reconstruction.
METHODS: Gynemesh was prepared by the chemical reduction method in the liquid-phase, and observed histologically. Then its thickness, elongation at break, tensile strength, and elasticity modulus were detected. Eight female New Zealand rabbits were used to make pelvic floor dysfunction models by a vaginal balloon, and randomly assigned into experimental group (pelvic floor reconstruction using Gynemesh) or control group (vaginal wall repair and hysterectomy), respectively. Thirty days post surgery, the Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20) were detected and compared between two groups.
RESULTS AND CONCLUSION: The Gynemesh had a thickness of (0.37±0.14) mm, an elongation at break of (25.35±2.68)%, a tensile strength of (7.69±1.17) MPa, and an elastic modulus of (0.007±0.008) GPa. Under the light microscope, a large amount of pink collagen fibers arranged neatly on the Gynemesh, but no blue nuclear material and residual cells existed. Under the scanning electron microscope, the fibers were tightly packed with no residual cells on the Gynemesh. At 30 days after surgery, the Gynemesh was not degraded and no erosion reaction occurred in the experimental group. Moreover, the experimental group had a lower incidence of complications compared with the control group (P < 0.05). These findings indicate that the Gynemesh has good biological performance and it is an ideal material for pelvic floor reconstruction.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

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