犬获得性食管气管瘘模型建立及食管双瓣修补术实验研究

Establishment of Canine Tracheoesophageal Fistula Model and Experimental Study of Esophageal Double Patch Repair

目的:1.建立犬食管气管瘘动物模型;2.观察食管壁双瓣修补气管缺损术局部组织病理学改变、愈合情况及该术式的治疗效果。方法:犬16只,随机分为2组,实验组(12只)建立犬食管气管瘘动物模型,行食管壁双瓣修补气管缺损术,对照组(4只)正常犬作为空白对照,术后支气管镜检查,术后1,2,8周处死动物,观察实验动物一般情况、修补局部的大体改变和组织病理学改变,测定气管狭窄指数。结果:成功建立了犬食管气管瘘动物模型;食管双瓣修补术后,实验组动物呛咳症状消失,均存活至预定时间,修补瓣和气管之间愈合良好,修补瓣血供良好,未出现气管狭窄情况,气管通畅度良好。结论:通过手术方式建立食管气管瘘模型方法可靠;食管双瓣修补术治疗TEF效果良好,值得进一步研究及推广。

Objective：1.To establish the canine model of tracheoesophageal fistula;2.To observe the pathological changes and healing process of the anastomosis between the patch and trachea and the effect of esophageal double patch repairing tracheal defects.Methods：16 dogs were randomly divided into 2 groups.Experimental group（12 dogs） were used to establish the tracheoesophageal fistula model and implement esophageal double patch repairing tracheal defects.Control group（4 dogs） were as a blank control with no treatment.Postoperative bronchoscopy was carried out at 4 weeks postoperative.The animals were sacrificed at 1,2 and 8 weeks postoperative.The general conditions of animals,gross and histological character of the specimens and tracheal stenosis index were examined.Results：Canine tracheoesophageal fistula model was established successfully.All animals of experimental group survived to the scheduled time.The anastomosis between the patch and trachea healed up well;good blood supply was found in the patch;the situation of tracheal stenosis did not appear.Conclusion：The surgical method of establishing TEF model seems to be suitable for further investigations on major surgery.The method of using the esophageal double patch to close the defect on the trachea has a favorable outcome,deserving further research and generalization.