目的

研究大鼠切口疝腹膜前间隙补片修补术后不同时间血清中血管内皮生长因子（VEGF）和血管生成素-1（Ang-1）的变化情况，探索补片与组织的融合速度。

方法

选用120只SD 大鼠，随机分为对照组，切口疝模型组，无疝植入补片组术后1、4、8、12 周组，有疝补片修补组术后1、4、8、12 周组，每组大鼠12 只。将聚丙烯补片植入无疝植入补片组和有疝补片修补组大鼠的腹膜前间隙。对照组取正常大鼠的血液，切口疝模型组取造模术后2 周的血液，无疝植入补片组和有疝补片修补组取植入补片术后1、4、8、12 周的血液，测量血清中VEGF、Ang-1含量。

结果

与对照组相比，切口疝模型组血清中VEGF 及Ang-1 浓度均明显升高（P＜0.05），无疝植入补片组术后1 周组VEGF 及Ang-1 浓度均升高（P＜0.05），术后4、8、12 周组VEGF 浓度差异无统计学意义（P＞0.05），而术后4、8 周组Ang-1 浓度有所升高（P＜0.05），术后12 周组无统计学意义（P＞0.05）；与切口疝模型组相比，有疝补片修补组术后1、4、8 周组的VEGF 及Ang-1 浓度差异无统计学意义（P＞0.05），术后12 周组VEGF 浓度降低（P＜0.05），Ang-1 浓度无明显差异（P＞0.05）；与无疝植入补片组各个时间段对比，有疝补片修补组术后12 周组Ang-1水平升高（P＜0.05），其余各时间段VEGF 及Ang-1 浓度均无明显差异（P＞0.05）。

结论

大鼠腹外疝腹膜前间隙补片修补术后，手术创伤引起血清中VEGF 及Ang-1 显著增高，而补片异物的刺激并未引起血清中VEGF 及Ang-1 额外的显著增高，说明补片与组织的融合可能是一个缓慢的过程，提示手术后短期内应避免剧烈活动导致还没有与组织较好融合的补片移位。

Objective

To detect the changes of vascular endothelial growth factor (VEGF) and angiopoietin-1 (Ang-1) in serum at different times after preperitoneal space mesh repair for incisional hernia in rats, and explore the fusion rate of mesh and tissue.

Methods

A total of 120 SD rats were randomly divided into control group (n=12), incisional hernia model group (n=12), hernia-free mesh group 1, 4, 8, 12 weeks after surgery (n=12 in each group), and 1, 4, 8 and 12 weeks after hernia mesh repair(n=12 in each group).Implant polypropylene mesh into the preperitoneal space of rats in the hernia-free implantation mesh group and the hernia mesh repair group.The control group took the blood of normal rats, the incision hernia model group took the blood 2 weeks after modeling, and the blood of 1, 4, 8 and 12 weeks after the implantation mesh was taken from the hernia implant-free mesh group and the hernia mesh repair group, and the VEGF and Ang-1 contents in serum were measured.

Results

Compared with the control group, the serum concentrations of VEGF and Ang-1 in the incisional hernia model group increased significantly (P＜0.05), the concentrations of VEGF and Ang-1 increased (P＜0.05) in the group without hernia implantation mesh group 1 week after surgery, and there was no significant difference in VEGF concentration in the 4, 8 and 12 weeks after surgery (P＞0.05), while the concentration of Ang-1 increased in the 4 and 8 weeks postoperative group (P＜0.05), and there was no significant difference in the group 12 weeks after surgery (P＞0.05); Compared with the incision hernia model group, there was no significant difference in VEGF and Ang-1 concentrations in the hernia mesh repair group at 1, 4 and 8 weeks after surgery (P＞0.05), and the VEGF concentration decreased (P＜0.05) and Ang-1 concentration (P＞0.05) in the hernia mesh repair group.Compared with the hernia implantation mesh group, the level of Ang-1 increased (P＜0.05) in the hernia mesh repair group 12 weeks after surgery, and there was no significant difference in VEGF and Ang-1 concentrations in the remaining periods (P＞0.05).

Conclusion

After preperitoneal space mesh repair for extra-abdominal hernia in rats, surgical trauma caused a significant increase in VEGF and Ang-1 in serum, while stimulation of the mesh foreign body did not cause an additional significant increase in VEGF and Ang-1 in serum, indicating that the fusion of mesh and tissue may be a slow process, suggesting that strenuous activities should be avoided in the short term after surgery, resulting in the displacement of mesh that has not been well integrated with tissue.