肌瓣对自体及异体气管移植段血液循环建立的促进作用  

Enhancement of revascularization in orthotopic canine tracheal autografts and allografts with muscular wrapping

作　　者：卢强[1] 李小飞[1] 王律[1] 韩勇[1] 闫小龙[1] 

机构地区：[1]第四军医大学唐都医院胸外科,陕西西安710038

出　　处：《第四军医大学学报》2004年第23期2127-2129,共3页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金 (39970 70 7) ;陕西省自然科学基金(99SM37)

摘　　要：目的 :探讨采用肌瓣包裹促进自体及异体气管移植段重建血运的方法 .方法 :将 30只杂种犬随机等分为 3组 ,均切取颈部 5环气管段作为移植段 .A组 :无肌瓣包裹自体移植组 ;B组 :采用自体双侧胸骨舌骨肌 胸骨甲状肌联合肌瓣包裹组 ;C组 :采用异体双侧胸骨舌骨肌 胸骨甲状肌联合肌瓣包裹组 .于术后 1,2 ,4和 8wk处死动物取材 ,观察和比较实验动物的存活情况、移植体气管标本的大体和组织学改变 ,以及新生微血管密度 (MVD)等指标 .结果 :无肌瓣包裹自体移植组不能维持管腔结构 ;自体肌瓣包裹组移植段血供良好 ,管腔通畅 ,狭窄程度轻 ,存在炎症反应 .异体肌瓣包裹组移植体血供尚可 ,炎症反应重 ,管腔狭窄 ,但仍可维持通畅 .结论 :移植体的狭窄现象与血供关系密切 .肌瓣包裹气管自体移植段能够诱导出新生血管 ,维持气管形态 ,移植的气管可以存活 8wk以上 .自体较异体移植段血供好 ,虽可维持气管通畅 ,但存在狭窄 .AIM: To examine the effect of muscular wrapping for revascularization on airway healing in tracheal autografts/ allografts model. METHODS: Thirty mongrel dogs were randomly divided into 3 groups: autotransplantation without muscular wrapping (Group A), autotransplantation with muscular wrapping (Group B), and allotransplantation with muscular wrapping (Group C). A five-ring cervical tracheal segment was harvested as the grafts. The animals were sacrificed at 1, 2, 4 and 8 wk postoperation. The survival of the animals, gross and pathological characteristics of the specimens, and the neogenetic microvessel density were compared between the groups. RESULTS: The autografts failed to maintain their structure integrity without muscular wrapping in group A. In the muscular wrapping groups, the grafts maintained their structures, surrounded by well-vascularized connective tissues, and infections occurred around the grafts. CONCLUSION: Stenosis of tracheal grafts is closely correlated with blood supply. The autografts with muscular wrapping can induce new microvessels and maintain normal structure. The autografts can survive over 8 weeks. The allografts are surrounded by well-vascularized connective tissues and can keep trachea unobstructed, but with some stenosis.

关 键 词：气管移植 血液循环 肌瓣 

分 类 号：R655.3[医药卫生—外科学]