城垛状磁吻合装置的设计与实验研究

Design and experimental study of battlement-shaped magnetic compression device

目的 :设计一种城垛状磁吻合装置(magnetic compression device,MCD),并验证其在消化道重建术后实现吻合口长期通畅的可行性。方法:城垛状MCD由母环和子环组成。母环为城垛状结构,吻合面采用纯铁加工,并雕刻8个放射状凹槽;子环为圆形磁体,采用N54钕铁硼加工。采用0.6、0.8、1.0、1.2 mm 4种凹槽宽度的城垛状MCD对成年家兔行小肠吻合术(城垛状MCD组),并与等尺寸的传统圆形MCD进行对照(对照组),观察实验动物的磁体排出情况、术后并发症、吻合口粘连评分及吻合口形态、爆破压和周长等。结果:城垛状MCD组与对照组的术后并发症、吻合口粘连评分及吻合口形态、爆破压没有差异。城垛状MCD的凹槽宽度为0.8 mm时,吻合口周长大于对照组,且长期稳定未见狭窄。而城垛状MCD的凹槽宽度为1.0 mm和1.2 mm时,发生磁体未排现象,无法形成完整的吻合口。结论:城垛状MCD可实现术后吻合口长期通畅,能够满足以较小尺寸预防吻合口狭窄的临床需求。

Objective To design a battlement-shaped magnetic compression device(MCD) and verify its feasibility for maintaining long-term patency of the anastomosis after digestive tract reconstruction. Methods A battlement-shaped MCD was designed composed of a master link and a sub link. The master link had a battlement-shaped structure with pure iron anastomosis surface and 8 radiating grooves;the sub link had a round structure made of N54 NdFeB magnet. Small intestine anastomosis was performed on adult rabbits in an experimental group(battlemented-shaped MCD group) with the battlementshaped MCD of four groove widths of 0.6, 0.8, 1.0, and 1.2 mm, and in a control group with the conventional round MCD of equal size. The experimental rabbits were observed in terms of the magnet expulsion, postoperative complications,anastomotic adhesion score, anastomotic morphology, burst pressure and perimeter. Results There were no differences in the postoperative complications, anastomotic adhesion scores, anastomotic morphology and burst pressure between the battlement-shaped MCD group and the control group. In case of 0.8 mm width groove the battlement-shaped group had the anastomotic perimeters greater than those of the control group, and there were no anastomotic strictures found during long-term observation;in case of 1.0 mm and 1.2 mm grooves the magnet was not expulsed from the body so that complete anastomosis could not be formed. Conclusion The battlement-shaped MCD contributes to long-term postoperative anastomotic patency,which prevents anastomosis stenosis inspite of a small size. [Chinese Medical Equipment Journal,2022,43(6):31-35,45]