聚酯聚丙烯复合人工气管重建气管的实验研究

An Experimental Study of Polyester and Polypropylene Combined Tracheal Prosthesis in Reconstruction of the Trachea

目的：探讨微孔聚酯聚丙烯复合人工气管重建气管的效果。方法：将１７只犬分成２组，在手术切除部分颈段气管后，Ｉ组（１２只）用６ｃｍ长的人工气管作置换，采用可吸收性合成（ｍａｘｏｎ）缝线吻合１１只，用聚丙烯（ｐｒｏｌｅｎｅ）缝线吻合１只。Ｉ组（５只）用４ｃｍ长的人工气管作置换，其中３只用ｍａｘｏｎ缝线吻合，２只用ｐｒｏｌｅｎｅ缝线吻合。结果：２组实验犬经术后最长３６９天的观察，存活并保持人工气管通畅者１４只（８２．４％），其中Ｉ组９只、Ｉ组５只。Ｉ组中３只因发生吻合口漏于术后１４～１５天死亡。本组人工气管有利于内壁长入成纤维细胞和被覆纤维结缔组织。术时应用舌骨下肌层严密包覆移植材料，术后未见人工气管发生漏气。２组中各１只采用ｐｒｏｌｅｎｅ缝线吻合犬分别在移植６５天和３６９天扫描电镜检查见有纤毛柱状上皮长入。

Objective:To study the efficacy of polyester and polypropylene combined tracheal prosthesis in reconstruction of trachea .Methods:Surgical replacement of a segment of cervical trachea was performed in 17 dogs.In group I,a 6 cm long tracheal prosthesis was implanted in 12 dogs.Both absorbable maxon sutures(n=11)and prolene sutures(n=1)were used.In group II,a 4 cm long tracheal prosthesis was implanted in 5 dogs using maxon sutures(n=3)and Prolene sutures(n=2).Results:3 dogs died from anastomotic leakage on postoperative day 14 15.14 of 17 dogs(82.4%)maintained a patent prosthetic implant and survived a postoperative observation of 369 days.Circum ferential wrapping of subhyoid muscle about the prosthesis at the time of implantation was proved to provide a well formation of an adherent outer capsule with no signs of air leak.Ingrowth of fibroblast cells and covering of connective tissues were also demonstrable .In two prolene sutured tracheal prostheses implanted 365 369 days postoperatively revealed the ingrowth of ciliated columnar epithelium near both anastomotic areas.Conclusion:The feasibility of the polyester and polypropylene combined tracheal prosthesis in reconstruction of the trachea is warranted.