聚四氟乙烯人工气管移植的形态学及病理学变化

发布时间：2018-02-19 19:06

本文关键词： 人工气管气管重建聚四氟乙烯上皮化兔　出处：《中国修复重建外科杂志》2014年07期 　论文类型：期刊论文

【摘要】：目的观察聚四氟乙烯人工气管体内植入后的形态学及病理学变化。方法取聚四氟乙烯微孔管,其外包绕聚丙烯螺旋丝,预制成人工气管。取新西兰白兔40只,体重4~5 kg,切除颈段气管2 cm,制备气管缺损动物模型。实验组(n=20)用人工气管与气管上、下端端吻合;正常对照组(n=20)行一期气管端端吻合术。术后观察动物存活情况,并于术后2、4、6个月行X线片观察,取材行大体观察、组织学观察;对移植前后人工气管行纵向拉伸及径向支撑生物力学试验,并与正常对照组比较。结果实验组15只动物存活超过2个月并保持人工气管通畅;术后4个月以后人工气管外组织生成类似气管样组织,可填充缺损区域;同期正常对照组动物全部存活。术后各时间点X线片示实验组人工气管均无明显移位,位置保持良好;正常对照组均未见气管狭窄。组织学观察示,实验组术后2个月人工气管内壁无明显上皮组织;4个月人工气管内壁有部分上皮细胞覆盖,未完全内皮化,未见气管纤毛柱状上皮,气管各层次不完整;6个月人工气管内壁基本被上皮细胞覆盖,并出现部分气管纤毛柱状上皮,基本具备了气管的生理功能。生物力学试验结果示,聚四氟乙烯人工气管移植后可保持稳定的生物力学性能,适用于兔气管重建。结论聚四氟乙烯人工气管可诱导受体气管内外组织生成气管样组织,气管各层次较符合生理学状态,实验动物可短期存活。
[Abstract]:Objective to observe the morphological and pathological changes of polytetrafluoroethylene (PTFE) artificial trachea implanted in vivo. The animal model of trachea defect was established by resecting the cervical trachea for 2 cm. The experimental group was treated with artificial trachea anastomosis with the upper and lower end of trachea and the normal control group with one-stage trachea end-to-end anastomosis. The survival of the animals was observed after operation. X ray films, gross observation and histological observation were performed at 2 and 6 months after transplantation, and longitudinal stretching and radial support biomechanical tests were performed on the artificial trachea before and after transplantation. Results 15 animals in the experimental group survived for more than 2 months and kept the artificial trachea unobstructed. At the same time, all the animals in the normal control group survived. X-ray films showed that the artificial trachea in the experimental group was not obviously displaced and the position was maintained well, and no trachea stenosis was found in the normal control group. In the experimental group, there was no obvious epithelium in the inner wall of the artificial trachea 2 months after operation, and there were some epithelial cells in the inner wall of the artificial trachea for 4 months, and no columnar epithelium of tracheal cilia. The inner wall of the artificial trachea was basically covered by epithelial cells, and some of the cilia columnar epithelium appeared in the trachea for 6 months, which basically possessed the physiological function of the trachea. Polytetrafluoroethylene (PTFE) artificial trachea can maintain stable biomechanical properties and be suitable for trachea reconstruction in rabbits. Conclusion PTFE artificial trachea can induce trachea-like tissue to form in and out of the recipient trachea. All levels of trachea were in a physiological state, and experimental animals could survive for a short time.
【作者单位】：西安交通大学第一附属医院胸外二科;西安交通大学第二附属医院肿瘤外科;西安交通大学第一附属医院病理科;西安交通大学第一附属医院手术部;
【分类号】：R318.13

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