分叉型气管支架的动物实验研究

发布时间：2018-11-26 19:16

【摘要】：目的通过犬气管内置入分叉型金属支架的动物实验研究,观察分叉型金属支架对正常犬气管组织的影响,为临床使用提供实验性数据。材料与方法采用多排CT对实验犬胸部进行薄层扫描,并行三维重建测量相关数据,根据实验数据计算出支架参数,制备出实验用分叉型金属支架。将实验组分为裸支架组与全覆膜支架组,每组各有6只犬。在全麻及透视下释放分叉型气管支架。支架置入后观察实验动物是否有呼吸困难、咳嗽、气喘等症状;分别于支架刚置入时及置入后2周、4周、8周,行薄层CT扫描,观测支架移位、贴壁情况、组织增生情况及肺内有无炎症、肺不张或肺气肿等病变。2周、4周、8周CT扫描后即将实验犬处死,观察相关的组织病理变化。结果支架置入后,裸支架组1只实验犬在支架置入后约4周时死亡,解剖发现肺内有炎症及肺梗塞现象。全覆膜支架组2只实验犬在支架置入后数小时内死亡,其余犬无呼吸困难、吞咽或者发声困难,短期内有轻度气喘,均有不同程度的长期咳嗽。1只犬置入全覆膜支架后4周CT扫描显示支架上移,其余支架无移位;有4只支架置入后位置或者贴壁不好。1只实验犬肺内存在炎症;2只实验犬肺内有炎症、肺梗塞及肺大泡;1只实验犬肺内有炎症、肺梗塞。裸支架组气管组织增生明显,全覆膜支架组,气道组织增生不明显。病理检查显示,裸支架组气管组织增生较全覆膜支架组明显,裸支架上边缘气管组织增生要比裸支架中段气管组织增生明显。全覆膜支架组上边缘气管组织增生与支架中段气管组织增生无明显区别。结论分叉型气管支架的操作释放容易,CT扫描可为支架的规格选择提供一定的依据,并且可做为支架置入后一种较好的随访方法;裸支架组气管组织增生较全覆膜支架组明显,并以支架上边缘为主。
[Abstract]:Objective to observe the effect of the branched metal stent on normal canine trachea tissue in order to provide experimental data for clinical use. Materials and methods Multi-row CT was used to scan the chest of experimental dogs. The experimental data were measured by 3D reconstruction. The parameters of the scaffold were calculated according to the experimental data and the branched metal scaffolds were prepared. The experimental group was divided into bare stent group and full-covered stent group with 6 dogs in each group. The branched tracheal stent was released under general anesthesia and fluoroscopy. The experimental animals were observed for dyspnea, cough, asthma and other symptoms after implantation of the scaffold. Thin CT scanning was performed at the time of stent implantation and at 2 weeks, 4 weeks and 8 weeks after implantation, respectively. The displacement of stent, adherence to the wall, tissue proliferation and pulmonary inflammation, atelectasis or emphysema were observed at 2 weeks, 4 weeks after implantation, respectively. The dogs were killed after 8 weeks CT scanning and the histopathological changes were observed. Results after stent implantation, an experimental dog in the bare stent group died about 4 weeks after stent implantation. Inflammation and pulmonary infarction were found in the lung by dissection. Two dogs in the full covered stent group died within a few hours after implantation of the stent. The remaining dogs had no dyspnea, dyspnea or dysphonia, and mild asthma in a short period of time. The CT scan showed the stents moved upward 4 weeks after the implantation of the stents, but the rest did not. There were four stents in the lung, one dog had inflammation in the lung, two dogs had inflammation, pulmonary infarction and bullae, and one dog had inflammation and pulmonary infarction. The proliferation of tracheal tissue was obvious in bare stent group, but was not obvious in full covered stent group. Histopathological examination showed that the proliferation of tracheal tissue in bare stent group was more obvious than that in full covered stent group, and the proliferation of tracheal tissue in upper edge of bare stent was more obvious than that in middle tracheal tissue of bare stent group. There was no significant difference between the upper marginal tracheal tissue proliferation and the middle tracheal tissue proliferation in the full covered stent group. Conclusion the operation and release of branched tracheal stent is easy, CT scan can provide some basis for the choice of stent size, and can be used as a better follow-up method after stent implantation. The proliferation of tracheal tissue in bare stent group was more obvious than that in full covered stent group, and the upper edge of stent was dominant.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R-332

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