医用纱布留置腹腔时间推断的初步研究

目的比较不同时间异物多核巨细胞数、细胞核数、Ⅰ/Ⅲ型胶原纤维及Ⅰ型胶原纤维/嗜银纤维比例的变化,推断异物（医用纱布）遗留腹腔时间。方法采用F344大鼠腹腔留置医用纱布的方法制作异物遗留腹腔2,8,30,120d的动物模型,肉眼观察大网膜包裹异物程度,HE染色观察异物多核巨细胞数、细胞核数变化,天狼猩红偏振光法观察Ⅰ/Ⅲ型胶原纤维比例变化、银染法观察Ⅰ型胶原纤维/嗜银纤维比例变化,并用图像分析系统对上述结果进行分析。结果随纱布留置腹腔时间延长,异物多核巨细胞数、细胞核数及Ⅰ/Ⅲ型胶原纤维比例、Ⅰ型胶原纤维/嗜银纤维比例逐渐上升,差异均具有统计学意义（P〈0.01）。Ⅰ型胶原纤维/嗜银纤维比例与纱布留置腹腔天数之间存在Power函数关系：Days=23.5[Proportion]^1.6,r=0.972。结论异物多核巨细胞数、细胞核数、Ⅰ/Ⅲ型胶原纤维及Ⅰ型胶原纤维/嗜银纤维比例变化规律有助于异物（纱布）遗留腹腔时间推断。

Primary study on estimation of time for gauze swabs left in rat abdomen

Objective To estimate time of gauze swabs left in abdomen with comparison of the number of foreign body giant cells,theirs nuclei and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers in different times.Methods F344 rat models dependent 2,8,30,120 days were established by gauze swab fixed in the abdomen,and were studied on gauze swab wrapped by greater omentum,the number of foreign body giant cells and theirs nuclei by HE staining,and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers by sirius red and silver staining respectively.The results were analyzed by image analysis system.Results The results showed that number of foreign body giant cells,theirs nuclei and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers increased gradually(P<0.01)followed the time delayed.The Proportion of type Ⅰ collagenous fibers to argentaffin fibersis Power Function of Days of guaze swab left in rat abdomen(r=0.972).Conclusion The number of foreign body giant cells,theirs nuclei and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers contribute to the estimation of foreign body(eg.gauze swab)left in abdomen.