异体真皮脱细胞组织补片在治疗复杂性尿道狭窄中的应用.docVIP

异体真皮脱细胞组织补片在治疗复杂性尿道狭窄中的应用 　　作者：黄超，杨风光，张延榕，何延瑜 作者单位：福建医科大学 省立临床学院泌尿外科，福州 350001 　　【摘要】 目的 观察人同种异体真皮脱细胞组织补片(AMG)治疗复杂性尿道狭窄的尿道重建中的临床疗效，寻求理想的尿道修复材料。 方法 以AMG作为尿道重建的替代材料，治疗男性复杂性尿道狭窄患者25例，术中将AMG缝合成管状，替代缺损尿道，术后4周拔除导尿管。 结果 尿管拔除后恢复排尿25例，尿道造影显示尿道连续性好，术后1年膀胱尿道镜示AMG腔表面已被尿路上皮细胞覆盖，与自体尿道不可分辨。术后2～6月再发尿道再狭窄4例，其中2例行尿道扩张术，2例行尿道内切开术，患者可通过尿道正常排尿。 结论 AMG是较理想的尿道替代材料，适合于多段或长段的尿道狭窄或缺损。 　　【关键词】 尿道;尿道狭窄; 真皮 ; 细胞外基质 ; 移植, 同种 　　Homologous Dermal Acellular Matrix Graft for Urethral Reconstruction in Treatment of Complex Urethral Stricture 　　HUANG Chao,YANG Fengguang,ZHANG Yanrong,HE Yanyu 　　Department of Urology, Fujian Provincial Hospital; Provincial Clinical College, Fujian Medical University, Fuzhou 350001, China 　　ABSTRACT: Objective To evaluate homologous dermal acellular matrix graft (AMG) for urethral reconstruction in the treatment of complex urethral stricture and to find an ideal replacement material to simplify the urethroplastic surgery. Methods Twentyfive male patients with complex urethral stricture were treated with allograft of tissue engineering material AMG, which was sutured into a tubular graft to replace the defective urethra. The catheters were retained in the reconstructed urethrae for 4 weeks. Results All 25 patients were voiding well after the removal of the catheters. Urethrography revealed excellent urethral continuity of the reconstructed urethra. Urethroscopic examination showed the graft urethra was covered by epithelial tissue and grew into the native tissue.Stenosis developed in 4 patients 2～6 months after the operation，of which 2 patients received transurethral incision and the other 2 urethral sounding. Conclusion The homologous dermal acellular matrix graft may serve as an ideal replacement material for complex urethral stricture or defect.To investigated the value of homologous dermal acelular matrix graft(AMG) for urethral reconstruction in treatment of complex urethral stricture，and found an ideal replacement material to simplify the