同种异体气管移植的病理学研究

Pathological Research on the Allogeneic Artificial Trachea Transplantation

目的探讨同种异体气管移植的临床效果及吻合口病理学变化。方法异体羊新鲜心包经过0.625%戊二醛处理后,包绕6cm Sigma不锈钢丝网支架,制成人工气管。切除实验用羊颈段气管5cm,人工气管与实验羊断端气管头尾端吻合。手术后60、120、180d行支气管镜检查、X线片检查,定期处死实验羊行人工气管病理学检查,观察人工气管、吻合口愈合、血运及肉芽组织情况。结果人工气管可以诱导受体羊气管周围组织生成气管样组织,填充缺损区。60d,移植区上皮组织不明显;120d,移植区覆盖有部分纤毛柱状上皮,气管各层次比较完整;180d,黏膜层有纤毛柱状上皮覆盖,黏膜下层、外膜等小血管丰富,移植区气管各层次完整。结论人工气管可以诱导受体羊气管周围组织生成完整的气管样组织,气管各层次比较完整,实验动物有望长期存活。

Objective To research a kind of artificial trachea which could biologically fuse with autolo-gous trachea.Methods Firstly allergenic fresh sheep pericardium treated by 0.625% glutaraldehyde were used to surround a 6cm long Sigma stainless steel wire net stents to prepare the artificial trachea.Then re-sected a 5 cm long cervical trachea of the sheep and sutured the upper and lower end with the artificial tra-chea and observed the healing of artificial trachea by X-ray and bronchoscopic examination on 60,120 and 180 days after the operation.Pathological examination was performed at regular intervals to observe the healing of anastomotic stoma,blood circulation and conditions in artifical trachea to supply theoretical ba-sis for the clinic.Results The artificial trachea and autologous trachea healed together in all of 12 animals and trachea like tissues formed to fill the defect area but the change needed sufficient time.On the day 60 after the operation there was no obvious ciliated columnar epithelium in the transplanting area. However, on the day 120 after operation,there was a small quantity of ciliated columnar epithelium but the tissues were not complete.On the day 180 after operation,the tissues of trachea in transplanting area were rela-tively complete-the mucosa was covered by ciliated columnar epithelium, small blood vessels were abun-dant in the mucosa and submucosa and gland could be seen.Conclusion Artificial trachea could induce the receptor trachea tissues to form a complete trachea,each lay of the trachea is relatively complete and the experiment animals can be long-term survived.