【摘要】 以聚四氟乙烯人造血管为主体,两端压制钛金属支撑环集成构建一种新型复合型人工气管。制作犬颈段气管缺如模型,用复合人工气管重建呼吸道。通过犬体内移植动物实验观察复合型人工气管初步效果和影响长期生存的因素。直接移植复合人工气管作为对照组(n=8),复合人工气管移植后加生长因子等改善组织环境作为实验组(n=8)。术后定期气管镜检查以及处死后组织检查评价复合型人工气管移植效果。16只实验动物复合型人工气管均顺利完成移植,无手术死亡。一月后各组吻合口处有肉芽增生。对照组4只犬因移植后呼吸困难死亡,实验组有2只死亡。死亡犬经解剖标本显示吻合口感染、裂开,气道狭窄,人工气管移位脱落。其余犬按计划14月后处死。实验组平均生存时间长于实验组(558.6dvs 401.8d,P<0.05);实验组吻合口感染、裂开、重度狭窄以及意外死亡的发生率均低于对照组(P<0.05)。犬处死后解剖显示复合人工气管已被纤维组织包裹,人工气管腔内未见内膜生长。以聚四氟乙烯为主体连接支撑钛环的新型复合型人工气管替代自体气管重建气道,恢复气道通畅性,能保持移植物不变形。人工气管的复合设计减轻了吻合口狭窄,而感染和裂开仍是复合型人工气管移植的主要并发症,影响动物长期生存。应用生长因子改善局部环境可促进组织愈合。更多还原

【Abstract】 We developed and designed a new type of artificial trachea.The basic structure of the artificial trachea was polytetrafluoroethylene vascular prosthesis linked with titanium rings on both sides.Dualmesh was sutured on titanium rings.This experimentation follows the replacement of trachea in dogs with a combined artificial trachea to investigate the feasibility of this type of prosthesis.Sixteen dogs were implanted with the combined artificial trachea after resection of 5cm of cervical trachea.The 5cm-long trachea of dogs on the necks were resected and the reconstruction of the defect of the trachea was performed with trachea prosthesis.According to the method of trachea reconstruction,the models were divided into 2groups,artificial trachea implantation group(the control group,n=8)and group of artificial trachea implantation with growth factor(the experimental group,n=8).Then computer tomography scan(CT),bronchoscope and pathologic examination were conducted periodically to observe the healing state of the hybrid artificial trachea.None of the dogs died during operation of cervical segmental trachea construction.But four dogs in the control group died of apnea in succession because artificial trachea was displaced and the lumen was obstructed,while 2dogs died in the experimental group.In the first month there was granulation around anastomosis with slight stenosis.The rest of dogs were well alive until they were sacrificed 14months later.The mean survival time of the experimental group was longer than that of the control group.The rate of infection,anastomotic dehiscence,severe stenosis and accidental death in the experimental group were lower than the control group(P<0.05). Artificial trachea was encapsulated by fibrous tissue and no mucous membrane was seen in the lumen of the artificial trachea.The artificial trachea can be used to reconstruction of the defect of the trachea with long-term survival of the animals.The unique design of artificial trachea reduces stenosis around anastomosis effectively but infections and split or displacement of the artificial trachea are still major problems affecting long-term survival of the animals.Application of growth factors to a certain extent promotes tissue healing by changing the local environment.更多还原