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关键词：输尿管；细胞外基质；移植
摘要 目的 寻求理想的输尿管替代材料。 方法 将20只兔双侧输尿管脱细胞处理后制成输尿管细胞外基质(ECM)；另60只兔分为3组：输尿管ECM移植组(实验组)，对照组1及对照组2。 结果 实验组术后组织学检查显示1周时ECM边缘部腔内面已见移行上皮细胞，管壁有肌细胞长入。6周时取材ECM区已修复近正常输尿管组织结构。12、24周时IVU检查；输尿管显影良好，通畅。对照组1术后7～10天，移植的异体输尿管均坏死。对照组2输尿管缺损区6周时均被纤维包裹而明显增粗。在实验取得满意结果的基础上成功应用于临床。 结论 异体脱细胞输尿管细胞外基质为理想的输尿管替代材料。
Histo-engineering materialfor the replacement of ureter
LIU Liu ,LIANG Dejiang,SHEN Pengfei,et al.
Department of Urology,Beijing Ji Shui Tan Hospital,Beijing 100035
Abstract Objective To experiment thepossibility of allodecellular extracellular matrix for the replacement of ureter. Methods Extracellularmatrix was obtained from the ureters of 20 rabbits by decellularization process.60experimental rabbits were used and a 4cm segment of left ureter was resected in each.Inthe experimental group of 20 rabbits,the resected ureter was replaced by the allo-ureterECM.In the first control group of 20 rabbits the resected ureter was replaced by allografttransplantation of untreated ureter.In the second control group of rabbits the resectedureter site was left untreated for autoregeneration.The neoureter segment was studied withelectron-microscopy and immunohistochemical procedures. Results In the experimentalanimals,transitional epithelial cells and monocytes could be seen in the ECM area andfully filled up the area after 3 weeks.No stenosis and hydronephrosis were observed on IVU24 weeks after replacement of the resected ureter.The histological structure was not muchdifferent from a normal ureter.In the first control group with allografttransplantation,rejection and necrosis occurred 7～10 days after the transplantation.Inthe second conrol group of autoregeneration the studied area was embeded with fibrosistissue.On the basis of the experiment,ureter ECM has been successfully used in clinicalpractice. Conclusions Alloureter ECM might be anideal replacement material for ureter.
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