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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 85 -91. doi: 10.3877/cma.j.issn.1674-392X.2021.01.020

所属专题： 文献；

基础论著

不同类型疝补片对大鼠生殖功能的影响
张成鹏1, 徐芳1, 崔逸峰1, 刘嘉铭1, 赵郧政1, 张宇1, 王鑫1, 温富凯1, 陆朝阳1,†()   
  1. 1. 150001　哈尔滨医科大学附属第一医院肝脏和疝与腹壁外科
  • 收稿日期:2019-07-02 出版日期:2021-02-18
  • 通信作者: 陆朝阳

Effects of different types of hernia mesh on reproductive function in rats

Chengpeng Zhang1, Fang Xu1, Yifeng Cui1, Jiaming Liu1, Yunzheng Zhao1, Yu Zhang1, Xin Wang1, Fukai Wen1, Zhaoyang Lu1,†()   

  1. 1. Liver and Hernia and Abdominal Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
  • Received:2019-07-02 Published:2021-02-18
  • Corresponding author: Zhaoyang Lu
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引用本文：

张成鹏, 徐芳, 崔逸峰, 刘嘉铭, 赵郧政, 张宇, 王鑫, 温富凯, 陆朝阳. 不同类型疝补片对大鼠生殖功能的影响[J]. 中华疝和腹壁外科杂志(电子版), 2021, 15(01): 85-91.

Chengpeng Zhang, Fang Xu, Yifeng Cui, Jiaming Liu, Yunzheng Zhao, Yu Zhang, Xin Wang, Fukai Wen, Zhaoyang Lu. Effects of different types of hernia mesh on reproductive function in rats[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(01): 85-91.

目的

建立大鼠腹股沟疝实验模型，对比不同类型的疝修补网片对大鼠生殖功能的影响。

方法

选取30只成年雄性SD大鼠，（8.5±0.3）周，体质量（230±35）g。随机分成5组，每组6只。正常对照组（NC组）、假手术组（SO组）、轻型聚丙烯补片组（LWPP组）、重型聚丙烯补片组（HWPP组）和复合补片组（CM组）。NC组仅给予腹腔麻醉后下腹部脱毛处理，SO组仅分离右侧腹股沟区输精管后逐层缝合切口，而后3组分别实施右侧腹股沟区手术分离输精管，而后用各自相对应补片包绕输精管。术后3个月采集标本并制作病理切片，观察补片对大鼠睾丸、精子和输精管的影响。

结果

CM组与周围组织及精索轻度粘连，对睾丸输精管损伤较小，生殖细胞质量下降不明显。LWPP和HWPP组与周围组织粘连较重，对睾丸输精管损伤严重，生殖细胞质量下降明显，生殖功能受到影响，材质相同的聚丙烯补片中，LWPP的影响程度明显小于HWPP。5组精子活率、a+b级精子、摆动性、线性度、前向性及直线运动精子活率比较，差异均有统计学意义（P均<0.05）。SO组、CM组、LWPP组及HWPP组精子活率及a+b级精子与NC组比较，差异均有统计学意义（P均<0.05）；LWPP组及HWPP组精子活率及a+b级精子与SO组比较，差异均有统计学意义（P均<0.05）；LWPP组与HWPP组精子活率及a+b级精子比较，差异有统计学意义（P<0.05）。5组大鼠精子总数比较，差异无统计学意义（P>0.05）；5组大鼠精子密度、直线速度、曲线速度及鞭打频率比较，差异有统计学意义（P<0.05）。SO组、CM组、LWPP组及HWPP组精子密度与NC组比较，差异均有统计学意义（P均<0.05）；LWPP组及HWPP组精子密度与SO组比较，差异均有统计学意义（P均<0.05）；LWPP组与HWPP组精子密度比较，差异有统计学意义（P<0.05）。5组大鼠输精管管壁变化分级评分比较，差异有统计学意义（P<0.05）；术后3个月5组大鼠输精管腔内皱襞个数比较，差异有统计学意义（P<0.05）。

结论

不同类型的疝补片对雄性大鼠生殖功能的影响不同，轻量型大网孔补片对生殖功能造成的影响比重量型小网孔补片造成的影响小。CM组较LWPP组和HWPP组对生殖功能的影响小，造成的损伤轻。建议对需行腹股沟疝修补手术且有生育要求者，在有条件的前提下可推荐使用复合补片。

关键词: 疝，腹股沟, 大鼠, 补片, 生殖功能, 疝修补术
Objective

To establish a rat model of inguinal hernia repair and compare the effects of different types of hernia meshes on the reproductive function of rats.

Methods

Thirty adult male SD (Sprague Dawley) rats were selected, with a weekly age of (8.5±0.3) weeks and a body weight of (230±35) g. They were randomly divided into 5 groups, each group has 6 rats, which were normal control group (NC group), sham operation group (SO group), light-weight polypropylene mesh group (LWPP group), heavy-weight polypropylene mesh group (HWPP group) and composite mesh group (CM group). The NC group only underwent abdominal anesthesia for lower abdomen hair removal. The SO group only separated the incision in the right inguinal region and then sutured the incision layer by layer. The latter three groups were operated on the right inguinal region to separate the vas deferens and then it wrapped with the corresponding patches. Specimens were taken at 3 months after surgery and pathological sections were made to observe the effects of the patches on reproductive function in rat testis, sperm and vas deferens.

Results

The CM group was slightly adherent to the surrounding tissues and spermatic cords. The damage to the testicular and vas deferens was small, and the quality of germ cells was not significantly decreased. The polypropylene patch group adhered to the surrounding tissue more seriously, the damage to the testicular and vas deferens was very serious, the germ cell quality was significantly reduced, and the reproductive function was significantly affected. In the polypropylene mesh with the same material, the light mesh had a significant influence less than the heavy mesh. The sperm motility and a+b grade sperm rate of the 5 groups were significantly different (all P<0.05). Compared with NC group, sperm motility and a+b grade sperm of SO group, CM group, LWPP group and HWPP group were significantly different (P<0.05); Compared with the SO group, the sperm motility and the a+b grade sperm of the LWPP group and the HWPP group were significantly different (P<0.05); the difference was also statistically significant between LWPP group and the HWPP group (P<0.05). There was no statistically significant difference in the total number of sperm in the 5 groups (P>0.05); the difference in sperm density, linear speed, curve speed and whiplash frequency in the 5 groups was statistically significant (P<0.05). Compared with the NC group, the sperm density of SO group, CM group, LWPP group and HWPP group were statistically different (P<0.05); compared with SO group, the difference of sperm density of LWPP group and HWPP group was statistically significant (P<0.05); the difference in sperm density between LWPP group and HWPP group was statistically significant (P<0.05). There was a significant difference in the grading scores of changes in the vas deferens wall of the 5 groups (P<0.05); the comparison of the number of folds in the vas deferens of the 5 groups at 3 months after the operation was statistically significant (P<0.05).

Conclusion

Different types of hernia meshes have different effects on reproductive function in rats. The light-weight mesh has less impact on the reproductive function than the heavy-weight mesh. Composite meshes have less effect than the light-weight and heavy-weight polypropylene meshes on reproductive function and cause less damage. It is recommended that in the future, it is more appropriate to use a composite mesh for patients who require inguinal hernia repair and have fertility requirements.

Key words: Hernia, inguinal, Rat, Mesh, Reproductive functions, Herniorrhaphy surgery
表1 5组大鼠精子活力指标检测值的比较（%，±s）
组别 鼠数 精子活率 a+b级精子 摆动性 线性度 前向性 直线运动精子活率
NC组 6 63.00±1.03 31.42±2.19 59.21±4.68 40.63±3.42 57.19±1.84 16.01±2.39
SO组 6 56.28±2.10a 27.36±1.58a 53.82±2.61 32.29±2.72 50.63±1.38 9.72±1.19
CM组 6 58.18±2.25a 26.68±2.81a 51.58±1.27 32.21±.96 51.16±.74 9.56±1.39
LWPP组 6 51.94±1.70a,b,c 21.47±0.67a,b,c 53.73±1.61 37.29±2.65 55.22±2.06 9.21±0.42
HWPP组 6 48.92±2.88a,b,c,d 20.52±0.95a,b,c,d 42.99±5.04 25.93±5.06 46.47±4.73 6.79±0.88
F值   7.014 7.569 4.112 3.651 2.945 9.388
P值   0.006 0.004 0.010 0.018 0.040 <0.001
表2 5组大鼠精子活力指标检测值比较（±s）
组别 鼠数 精子总数(个) 精子密度(百万) 直线速度(百万/ms) 曲线速度(μm/s) 鞭打频率(μm/s)
NC组 6 164.00±9.56 69.85±3.15 2.04±0.17 7.51±0.10 13.18±1.75
SO组 6 159.25±16.88 56.68±3.87a 1.37±0.14 6.83±0.15 16.08±1.91
CM组 6 161.50±18.85 61.55±5.90a 1.58±0.13 6.92±0.28 14.75±0.45
LWPP组 6 163.17±21.03 51.93±3.62a,b,c 1.63±0.08 6.50±0.13 14.26±0.95
HWPP组 6 147.83±30.63 52.75±8.29a,b,c,d 1.11±0.21 5.98±0.28 18.78±2.22
F值   0.118 2.107 6.241 8.343 2.387
P值   0.975 0.011 0.001 0.000 0.078
图1 各组大鼠术后睾丸组织染色图片（HE，×200）
图2 各组大鼠术后输精管横截面染色图片（HE，×100）
表3 5组大鼠输精管管壁变化分级评分（分）
组别 例数 评分
NC组 6 5.0(4.0~5.0)
SO组 6 4.0(4.0~5.0)
CM组 6 4.0(4.0~5.0)a
LWPP组 6 3.0(3.0~4.0)a,b
HWPP组 6 2.0(2.0~3.0)a,b
F值   22.74
P值   P<0.0001
表4 术后3个月5组大鼠输精管腔内皱襞个数的比较（个，±s）
组别 鼠数 个数
NC组 6 4.60±0.33
SO组 6 2.83±0.31
CM组 6 2.16±0.30a
LWPP组 6 1.66±0.49a,b
HWPP组 6 0.67±0.33a,b,c
F值   17.01
P值   P<0.0001
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