疝疾病动物模型研究及新型疝修补材料应用进展

doi:10.12300/j.issn.1674-5817.2024.121

摘要/Abstract

摘要：

疝是普外科常见病和多发病，指体内器官整体或一部分离开正常的解剖位置，通过先天或后天形成的薄弱点、缺损或空隙进入其他部位。疝的发生机制复杂，与腹壁薄弱或腹腔内压增高等多种因素有关，临床表现多样，因类型、部位和严重程度的不同而有所差异。随着老龄化社会进程不断加剧，疝的发病率呈逐年上升趋势。动物模型作为研究疝疾病的重要手段，一方面能够检验新修补材料和新技术的安全性和有效性；另一方面有助于临床医师探索新的手术方式，并对某些疝疾病及其并发症的发生机制和新疗法展开研究。由于不同类型的疝疾病在病理生理机制上存在显著差异，其动物模型的建立方法和评价标准也呈现出明显的多样性。此外，动物模型的建立方法与实验目的密切相关，不同的实验目的对动物模型的要求各不相同。因此，根据不同的实验目的精准选择动物模型的建立方法，是确保研究顺利开展并取得可靠成果的关键。为此，本文综述了建立腹外疝（包括腹壁切口疝、腹股沟疝、脐疝、造口旁疝、嵌顿疝及盆底疝）、先天性膈疝、食管裂孔疝及脑疝动物模型的有效方法，详细分析了这些模型的优缺点及相关的评价标准；同时，总结了一些新型疝修补材料在临床前疝疾病动物模型研究中的应用，以期为疝疾病相关研究及治疗提供有价值的参考。

关键词: 疝, 动物模型, 修补材料, 研究进展

Abstract:

Hernia is a common and frequently occurring condition in general surgery, referring to the displacement of an organ or part of an organ from its normal anatomical position through a congenital or acquired weak point, defect, or space into another area. Its pathogenesis is complex, involving multiple factors such as abdominal wall weakness or increased intra-abdominal pressure. The clinical manifestations of hernia vary depending on its type, location, and severity. As the aging of the population continues to advance, the incidence of hernia has been increasing annually. Animal models serve as an important tool in hernia research. They enable the evaluation of the safety and efficacy of new repair materials and techniques, as well as assisting clinicians in developing new surgical methods and investigating the mechanisms and novel therapies for certain hernia diseases and their complications. Given the significant differences in the pathophysiological mechanisms of different types of hernia diseases, the methods and evaluation criteria for establishing animal models are highly diverse. Furthermore, the methods for establishing animal models are closely related to experimental objectives, and different experimental goals require different animal models. Therefore, selecting appropriate animal models based on experimental objectives is crucial for ensuring the smooth progress of research and obtaining reliable results. To this end, this review summarizes effective methods for establishing animal models for external abdominal hernias (including incisional hernia, inguinal hernia, umbilical hernia, parastomal hernia, incarcerated hernia, and pelvic floor hernia), congenital diaphragmatic hernia, hiatal hernia, and cerebral hernia. It provides a detailed analysis of the advantages, disadvantages, and evaluation criteria of these models. Additionally, this review summarizes recent preclinical applications of new hernia repair materials, aiming to provide references for animal experimental research in the field of hernia studies.

Key words: Hernia, Animal model, Repair material, Research progress

中图分类号:

Q95-33

费彬,郭文科,郭建平. 疝疾病动物模型研究及新型疝修补材料应用进展[J]. 实验动物与比较医学, 2025, 45(1): 55-66. DOI: 10.12300/j.issn.1674-5817.2024.121.

FEI Bin,GUO Wenke,GUO Jianping. Research Progress on Animal Models for Hernia Diseases and New Hernia Repair Materials[J]. Laboratory Animal and Comparative Medicine, 2025, 45(1): 55-66. DOI: 10.12300/j.issn.1674-5817.2024.121.

图/表 2

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疝疾病类型 Types of hernia	构建方法 Establishment Methods	实验动物 Laboratory Animals	优点 Advantages	缺点 Disadvantages
腹壁切口疝 Incisional hernia	手术诱发	猪	腹壁结构、生理功能与人类相似程度高，临床转化率较高^[3-4]	成本较高，手术、麻醉操作复杂^[3-4]
		犬	腹壁结构、腹腔压力变化规律等与人类相似^[7-8]	成本较高，饲养管理和手术麻醉操作复杂^[7-8]
		兔	成本较低，体型小，操作简单^[4,11-12]	腹壁厚度、强度与人类差异较大^[4,11-12]
		鼠	成本低，操作简单，模型重复性好^[4,13-15]	腹壁厚度、强度与人类差异较大^[4,13-15]
腹股沟疝 Inguinal hernia	自发	猪	疝的发生机制更贴合临床实际，可研究疾病自然发生过程^[17]	发生率低，样本获取难度大；遗传背景不明确^[17]
	自发	兔	成本较低；存在永不闭合内环口；体积大小适中，更适合腹腔镜手术操作训练^[18-19]	腹股沟区解剖与人类差距较大；不能形成疝，适用条件有限^[18-19]
	转基因	小鼠	可重复性强，多用于机制研究^[20]	技术难度及成本高，适用条件有限^[21]
	手术诱发	大鼠	可控制疝种类及严重程度，快速成模型^[22]	与临床实际差距较大，应用较少
脐疝 Umbilical hernia	自发	大鼠	发生机制更贴合临床，可用于基因的研究^[26]	个体差异大^[24]
造口旁疝 Parastomal hernia	手术诱发	大鼠	成本低，操作简单；模型重复性好^[28]	腹壁厚度、强度与人类差异较大
嵌顿疝 Incarcerated hernia	手术诱发	大鼠	简单易行，可控性和重复性好^[28-29]	疝内容物、疾病进展速度及治疗效果等多方面与临床存在一定差异^[28-29]
盆底疝 Pelvic floor hernia	手术诱发	犬	疝的发生机制更贴合临床实际情况^[31]	盆底局部解剖复杂，不易识别，与人类存在差异^[31]
盆底疝 Pelvic floor hernia	转基因	小鼠	可用于盆底疝的发病机制研究^[32]	技术难度及成本高，适用条件有限^[32]

疝疾病类型 Types of hernia	构建方法 Establishment Methods	实验动物 Laboratory Animals	优点 Advantages	缺点 Disadvantages
腹壁切口疝 Incisional hernia	手术诱发	猪	腹壁结构、生理功能与人类相似程度高，临床转化率较高^[3-4]	成本较高，手术、麻醉操作复杂^[3-4]
		犬	腹壁结构、腹腔压力变化规律等与人类相似^[7-8]	成本较高，饲养管理和手术麻醉操作复杂^[7-8]
		兔	成本较低，体型小，操作简单^[4,11-12]	腹壁厚度、强度与人类差异较大^[4,11-12]
		鼠	成本低，操作简单，模型重复性好^[4,13-15]	腹壁厚度、强度与人类差异较大^[4,13-15]
腹股沟疝 Inguinal hernia	自发	猪	疝的发生机制更贴合临床实际，可研究疾病自然发生过程^[17]	发生率低，样本获取难度大；遗传背景不明确^[17]
	自发	兔	成本较低；存在永不闭合内环口；体积大小适中，更适合腹腔镜手术操作训练^[18-19]	腹股沟区解剖与人类差距较大；不能形成疝，适用条件有限^[18-19]
	转基因	小鼠	可重复性强，多用于机制研究^[20]	技术难度及成本高，适用条件有限^[21]
	手术诱发	大鼠	可控制疝种类及严重程度，快速成模型^[22]	与临床实际差距较大，应用较少
脐疝 Umbilical hernia	自发	大鼠	发生机制更贴合临床，可用于基因的研究^[26]	个体差异大^[24]
造口旁疝 Parastomal hernia	手术诱发	大鼠	成本低，操作简单；模型重复性好^[28]	腹壁厚度、强度与人类差异较大
嵌顿疝 Incarcerated hernia	手术诱发	大鼠	简单易行，可控性和重复性好^[28-29]	疝内容物、疾病进展速度及治疗效果等多方面与临床存在一定差异^[28-29]
盆底疝 Pelvic floor hernia	手术诱发	犬	疝的发生机制更贴合临床实际情况^[31]	盆底局部解剖复杂，不易识别，与人类存在差异^[31]
盆底疝 Pelvic floor hernia	转基因	小鼠	可用于盆底疝的发病机制研究^[32]	技术难度及成本高，适用条件有限^[32]

疝疾病类型 Types of hernia	构建方法 Establishment methods	实验动物 Laboratory animals	优点 Advantages	缺点 Disadvantages
先天性膈疝 Congenital diaphragmatic hernia	转基因	小鼠	可模拟疾病自然发生；特定基因的功能研究^[37-38]	技术难度及成本高^[37-38]
	药物诱发	大鼠、小鼠	经济易行；可模拟人类膈疝不同严重程度的肺和膈胚胎发育研究^[39-41]	缺乏对大型动物的实验研究；存在硝基酚本身致畸作用的影响^[39]
	手术诱发	羊	胎儿尺寸大，易形成疝缺损^[44]	成本高，妊娠周期长，窝产仔数少；仅限于从小管期开始的胎儿肺的研究^[44]
		兔	成本较低，妊娠期短，窝产仔数多，肺部生理学与人类相似^[45-47]	仅限于从小管期开始的胎儿肺的研究^[45-47]
		大鼠	成本低，妊娠期短，窝产仔数多^[40]	手术操作难度大，需显微操作基础；仅限于从小管期开始的胎儿肺的研究^[40]
食管裂孔疝 Hiatal hernia	自发	猪	重要解剖结构与人类相似；多用作手术训练模型^[49-50]	成本高；麻醉、围术期监护等复杂^[49-50]
	自发	鼠、兔	简单易行^[51-52]	与临床差距较大；适用条件有限，近年来较少使用^[51-52]
	手术诱发	猪	重要解剖结构与人类相似；可作为手术训练模型^[53-54]	成本高；麻醉、围术期监护等复杂^[53-54]
	手术诱发	犬	重要解剖结构与人类相似^[55]	成本高；麻醉、围术期监护等复杂^[55]
脑疝 Cerebral hernia	手术诱发	广西巴马小型猪	大脑解剖及生理与人类相似；脑容积较大，易于影像学评估^[57]	成本高；麻醉、围术期监护等复杂^[57]
脑疝 Cerebral hernia	手术诱发	兔	病灶局限，可控性高^[58]	手术操作技术难度较大^[58]

疝疾病类型 Types of hernia	构建方法 Establishment methods	实验动物 Laboratory animals	优点 Advantages	缺点 Disadvantages
先天性膈疝 Congenital diaphragmatic hernia	转基因	小鼠	可模拟疾病自然发生；特定基因的功能研究^[37-38]	技术难度及成本高^[37-38]
	药物诱发	大鼠、小鼠	经济易行；可模拟人类膈疝不同严重程度的肺和膈胚胎发育研究^[39-41]	缺乏对大型动物的实验研究；存在硝基酚本身致畸作用的影响^[39]
	手术诱发	羊	胎儿尺寸大，易形成疝缺损^[44]	成本高，妊娠周期长，窝产仔数少；仅限于从小管期开始的胎儿肺的研究^[44]
		兔	成本较低，妊娠期短，窝产仔数多，肺部生理学与人类相似^[45-47]	仅限于从小管期开始的胎儿肺的研究^[45-47]
		大鼠	成本低，妊娠期短，窝产仔数多^[40]	手术操作难度大，需显微操作基础；仅限于从小管期开始的胎儿肺的研究^[40]
食管裂孔疝 Hiatal hernia	自发	猪	重要解剖结构与人类相似；多用作手术训练模型^[49-50]	成本高；麻醉、围术期监护等复杂^[49-50]
	自发	鼠、兔	简单易行^[51-52]	与临床差距较大；适用条件有限，近年来较少使用^[51-52]
	手术诱发	猪	重要解剖结构与人类相似；可作为手术训练模型^[53-54]	成本高；麻醉、围术期监护等复杂^[53-54]
	手术诱发	犬	重要解剖结构与人类相似^[55]	成本高；麻醉、围术期监护等复杂^[55]
脑疝 Cerebral hernia	手术诱发	广西巴马小型猪	大脑解剖及生理与人类相似；脑容积较大，易于影像学评估^[57]	成本高；麻醉、围术期监护等复杂^[57]
脑疝 Cerebral hernia	手术诱发	兔	病灶局限，可控性高^[58]	手术操作技术难度较大^[58]

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