目的

探究SD大鼠切口疝腹膜前间隙补片修补术后腹壁肌肉的病理变化情况。

方法

将48只SD大鼠随机分为正常对照组（8只）、切口疝模型组（8只）、补片修补组（术后1、4、8、12周组，各8只）。对照组取大鼠腹壁肌肉标本，切口疝模型组进行切口疝造模，于2周后取腹壁肌肉标本，补片修补组先进行切口疝造模，造模成功后行补片修补术，在植入补片后1、4、8、12周取腹壁肌肉标本，观察腹壁肌肉炎症细胞浸润及纤维组织增生情况。

结果

切口疝腹膜前间隙补片修补术后靠近腹膜的腹壁肌肉组织出现肌纤维坏死、炎细胞浸润、纤维组织增生。（1）炎细胞浸润程度：切口疝模型组与对照组相比，炎细胞浸润程度增高，差异有统计学意义（P＜0.05）；与切口疝模型组相比，补片修补组术后1周组炎细胞浸润程度显著增高，差异有统计学意义（P＜0.05），而补片修补组术后4、8、12周组炎细胞浸润程度无明显差异（P＞0.05）。（2）纤维组织增生程度：与对照组相比，切口疝模型组纤维组织增生程度增高，差异有统计学意义（P＜0.05）；与切口疝模型组相比，补片修补组术后1周组纤维组织增生程度增高（P＜0.05），而补片修补组术后4、8、12周组无明显差异（P＞0.05）。

结论

手术创伤及补片刺激均可致大鼠腹膜前间隙补片修补术后，靠近腹膜的腹壁肌肉组织出现肌纤维坏死、炎细胞浸润、纤维组织增生。此病理变化可能与临床上出现的腹膜前间隙补片修补术后补片置入区域活动时疼痛相关。

Objective

To investigate the pathological changes of abdominal wall muscles after preperitoneal space mesh repair of incision hernia in SD rats.

Methods

Forty-eight SD rats were randomly divided into normal control group （8 rats）， incisional hernia model group （8 rats）， hernia mesh repair group ［1 week postoperative group （8 rats）， 4 weeks postoperative group （8 rats）， 8 weeks postoperative group （8 rats）， 12 weeks postoperative group （8 rats）］. In the control group， rat abdominal wall muscle specimens were taken. In the incision hernia model group， incision hernia modeling was performed， and abdominal wall muscle specimens were taken after 2 weeks. The incision hernia modeling was performed first in the hernia mesh repair group， and mesh repair was performed after successful modeling， and abdominal wall muscle samples were taken 1， 4， 8， 12 weeks after implantation of the mesh，to observe the inflammatory cell infiltration and fibrous tissue proliferation of abdominal wall muscles.

Results

After incision hernia anterior peritoneal space mesh repair， fibrous necrosis， inflammatory cell infiltration， and fibrous tissue hyperplasia occurred in the abdominal wall muscle tissue close to the peritoneum. （1） Degree of inflammatory cell infiltration：compared with the control group， the degree of inflammatory cell infiltration was increased in the incision hernia model group， and the difference was statistically significant （P＜0.05）； compared with the incision hernia model group， the degree of inflammatory cell infiltration was significantly increased in the hernia mesh repair group 1 week after surgery， and the difference was statistically significant （P＜0.05）， while there was no significant difference in the degree of inflammatory cell infiltration in the hernia mesh repair group at 4， 8 and 12 weeks after surgery （P＞0.05）. （2） Degree of fibrous tissue hyperplasia：Compared with the control group， the degree of fibrous tissue hyperplasia was increased in the incision hernia model group and the difference was statistically significant （P＜0.05）； compared with the incision hernia model group， the degree of fibrous tissue hyperplasia was increased in the hernia mesh repair group one week after surgery （P＜0.05）， while there was no significant difference in the hernia mesh repair group 4， 8 and 12 weeks after surgery（P＞0.05）.

Conclusion

After preperitoneal space mesh repair in rats， both surgical trauma and mesh stimulation can lead to muscle fiber necrosis， inflammatory cell infiltration， and fibrous tissue hyperplasia in the abdominal wall muscle tissue close to the peritoneum. This pathological change may be related to the clinical movement pain in the mesh area after preperitoneal space mesh repair.