摘要
目的建立2 μm激光前列腺汽化切除术后前列腺部尿道再上皮化动物模型。
方法2016年3—4月选取未去势雄性中华田园犬15只，年龄（6.3±0.6）岁，范围5～7岁。体重（20.5±1.3）kg，范围18～22 kg。经腹腔注射水合氯醛麻醉后，行经膀胱2 μm激光前列腺汽化切除术，术中见前列腺凸向尿道，前列腺部尿道变窄。记录手术时间、麻醉苏醒时间、存活率、初次饮水时间、初次进食时间、初次站立时间、初次排便时间、膀胱冲洗液清亮时间、切口愈合时间。术后3 d及术后1、2、3、4周分别随机选择3只犬进行观察。沿原手术路径在膀胱镜下观察前列腺部尿道创面的修复情况，观察结束立即取膀胱、前列腺及前列腺远端部分尿道的连续组织行病理检查，分别观察大体标本，以及HE染色和免疫组化染色检查结果。
结果本组15只犬的手术时间为（70.5±18.3）min，范围50～90 min。麻醉苏醒时间为（120.1±21.1）min，范围95～145 min。15只犬术后均存活。术后初次饮水时间为（6.5±1.8）h，范围4.5～9.0 h；初次进食时间为（10.3±2.1）h，范围8.0～13.0 h；初次站立时间为（23.7±5.6）h，范围18.0～30.0 h；初次排便时间为（26.3±3.1）h，范围23.0～30.0 h。术后膀胱冲洗液清亮时间为（5.2±1.6）d，范围4～7 d。切口愈合时间为（8.7±1.5）d，范围6～11 d。膀胱镜观察，术后3 d和1周时创面被苍白坏死组织覆盖；2周时创面被覆上皮；3周时创面被覆上皮组织更厚；4周时前列腺部被覆上皮组织，与正常尿路上皮颜色接近。HE染色结果显示，术后3 d时创面未见上皮被覆；1周时少数创面已有点片状单层或2～3层立方再生上皮被覆；2周时创面均见被覆上皮覆盖，上皮为2～3层，缺乏极性；3周时创面被覆上皮细胞增厚至5～6层，表面可见少数伞细胞，极性排列；4周时创面被覆上皮为5～6层，表面见较多伞细胞，呈极性排列。免疫组化染色结果显示，术后3 d及1、2周时创面或被覆上皮尿斑蛋白（－）；3周时创面部分被覆上皮尿斑蛋白（＋）；4周时创面被覆上皮尿斑蛋白（＋）。
结论对中华田园犬行2 μm激光前列腺汽化切除术能成功建立前列腺部尿道再上皮化的动物模型。
ObjectiveTo establish a prostate urethral re-epithelialization model with Chinese rural canine by 2 μm laser vaporization resection.MethodsWe used 2 μm laser to vaporiz prostate of 15 uncastrated male Chinese rural canines from March to April in 2016.These canines mean age was （6.3±0.6） years（ranging 5-7 years）, and weight was （20.5±1.3） kg（ranging 18-22 kg）. We began to surgery in which we saw the protruding part of the prostate in urethra, and narrow prostate urethra after a successful anesthesia by intraperitoneal injection of chloral hydrate. The operation time, anesthesia time, survival rate, first time to drink water, first time to feed, first time to stand, first time to defecate, the time when canine bladders rinse became clear, wound healing time were recorded. After 3 days, 1 week, 2 weeks, 3 weeks and 4 weeks, we randomly select 3 canines to observe regeneration of prostate urethra wound under cystoscope. After surgery, the bladder, prostate and prostate distale urethra were removed to make specimen and measure the diameter size of prostate. The HE staining and immunohistochemistry was performed in each sample.
ResultsThe experimental operation time was （70.5±18.3） min （ramging 50-90 min）. The average anesthesia time was （120.1±21.1） min （ranging 95-145 min）. The survival rate was 100%.In post surgery duration first standing time, first eating time , first drinking water time, first defecation time were （6.5±1.8）h, （10.3±2.1）h, （23.7±5.6）h, （26.3±3.1）h, respectively. The time when canine bladders rinse became clear and wound healing time were （5.2±1.6）d, （8.7±1.5）d respectively. Cystoscopy observated that the wound was covered by pale necrotic tissue 3 d and 1 week after operation, covered by epithelium 2 weeks after operation, covered by more thicker epithelium 3 weeks after operation, covered by epithelium which color was close to normal urothelium 4 weeks after operation. HE staining observated that the wound wasn＇t covered by epithelium 3 d after operation, partial wound was covered by flaky single or 2-3 cubic regenerated epithelial 1 week after operation, all wound was covered by epithelial which was lack of polar 2 weeks after operation, wound was covered by polarity epithelium which was thicken to 5-6 layer and observated a little umbrella cells on the surface 3 weeks after operation, wound was covered by polarity epithelium which was thicken to 5-6 layer and observated much umbrella cells on the surface 4 weeks after operation. Immunohistochemical staining observated that urinary spot protein from the wound or epithelium was negative 3 d, 1 and 2 weeks after operation, urinary spot protein from the part of epithelium was positive 3 weeks after operation, and urinary spot protein from all epithelium was positive 4 weeks after operation.
ConclusionIt is feasible to establish prostate urethral re-epithelialization model in the Chinese rural canine by 2 μm laser vaporization resection of the prostate.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2018年第1期58-61,共4页
Chinese Journal of Urology
基金
贵州省优秀青年科技基金（2015）
关键词
激光
前列腺汽化切除术
再上皮化
Laser
Vaporization resection of prostate
Re-epithelialization
