肺组织瓣内衬壳聚糖支架对食管部分缺损的修补

Repairing partial esophagus defection with an inner chitosan stent in rabbits

目的:探讨肺组织瓣内衬壳聚糖管修补食管缺损的可行性.方法:取50只日本大耳白兔,随机分为2组,实验组25只,行自体肺组织瓣修补中段食管部分缺损(内衬壳聚糖管支架);对照组25只,无内衬支架,术后第2、4、8周时,大体及组织学观察缺损修补处肺组织瓣愈合情况,并于术后10wk对存活兔行钡餐透视观察食管通畅情况.随访观察剩余兔长期存活时间及死因.结果:45只实验动物存活超过2wk以上,围手术期死亡5只,死亡率10%,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10wk:食管钡餐检查见实验组食管钡剂通过顺利,无明显狭窄及反流,蠕动尚可,对照组轻度狭窄,无明显梗阻及反流.随访实验动物存活6-8mo,死亡原因与手术无关.结论: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防止狭窄.

AIM： To examine feasibility of patching esophagus damage with chitosan tube stent. METHODS： Fifty Japanese rabbits were randomly divided into two groups, experimental group （n = 25） which underwent patching centersection esophagus partial damages with body lung tissue petal （inside lining chitosan tube stent） and control group （n = 25） which underwent non-inside lining stent. At the 2^nd, 4^th, 8^th week after surgery, healing status was observed roughly and histologically. At the 10^th week after surgery, the survived rabbits were given barium meal to detect esophagus. The rabbits were followed up for survival time and death cause. RESULTS： Forty five experimental animals survived over two weeks. Five rabbits died during perioperative period with a 10% death rate.Reliable cicatrisation between the lung tissue petal and damage area, and squamose epidermis metaplasia were observed. At the 10^th week after surgery, the esophagus barium test showed that barium agents went through the esophagus smoothly, and there were no 6bvious stenosis or reflux and moderate peristalsis in the experiment group. However, there was mild stenosis and no obvious obstruction or reflux in the control group. Followed-up rabbits survived 6-8 months and their death cause was irrelevant to surgery. CONCLUSION： The lung tissue petal patching esophagus damage is one feasible method, and the chitosan tube, as the inside lining stent, may prevent narrowing.