肺组织瓣内衬壳聚糖管修补食管缺损的实验研究

Experimental Study of Repairing of Esophagus Defect with Lung Tissue Flap and an Inner Chitosan Tube Stent

目的探讨肺组织瓣内衬壳聚糖管修补食管缺损的可行性,以完成食管缺损的修复重建。方法15只日本大耳白兔,随机分为2组,对照组:5只,用自体肺组织瓣(无内衬壳聚糖管支架)修补中段食管部分缺损;实验组:10只,用自体肺组织瓣内衬壳聚糖管支架修补中段食管部分缺损。于术后第2周、4周和8周经大体和组织学观察缺损修补处肺组织瓣情况,术后10周对存活的兔行食管X线钡餐透视,观察食管通畅情况。结果围术期死亡5只。实验组6只兔存活超过2周以上,肺组织瓣与食管缺损处牢固愈合,肺组织瓣表面有鳞状上皮化生;术后10周食管X线钡餐检查见钡剂通过顺利,无明显狭窄和反流,蠕动良好。对照组4只兔存活超过2周以上,肺组织瓣与食管缺损处牢固愈合,肺组织瓣表面有纤维组织增生,术后10周食管X线钡餐检查见钡剂通过顺利,轻度狭窄,蠕动差,无明显梗阻和反流。结论采用肺组织瓣修补食管缺损是一种可行的方法,壳聚糖管可以作为内衬支架,以防止食管狭窄。

Objective To investigate the feasibility of lung tissue flap repairing esophagus defect with an inner chitosan tube stentin in order to complete repairing and reconsruetion of the esophagus defect. Methods Fifteen Japanese white rabbits were randomly divided into two groups, experiment group （n = 10）： esophagus defect was repaired with lung tissue flap having inner ebitosan tube stem; control group（n=5）： esophagus defect was repaired with lung tissue flap without inner ehitosan tube stent; and then the gross and histological apearanee in both groups were observed at 2, 4, 8 weeks after operation, barium sulphate X-ray screen were observed at 10 weeks after operation. Results Six rabbits survived for over two weeks in experiment group, lung tissue flap healed with esophageal defect, squamous metaplasia were found on the surface of lung tissue flap in experiment group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and no narrow or reversed peristalsis, the peristalsis was good in experiment group. Four rabbits survived for two weeks and the lung tissue flap healed with esophageal defect, fibrous tissue hyperplasy on the surface of the lung tissue flap in control group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and slight narrow or reversed peristalsis, the peristalsis was not good in control group, otherwise. Conclusion It is a feasible method to repair the esophageal defect with lung tissue flap with the inner chitosan stent.