不同直径人工硅橡胶肛门封堵器的封堵效果比较  

Occlusion effect comparison of artificial silicone rubber closure devices with different diameters

作　　者：张全安[1] 黄宗海[1] 史福军[1] 陈飞[1] 李建国[1] 邹兆伟[1] 

机构地区：[1]南方医科大学珠江医院,广东省广州市510282

出　　处：《中国组织工程研究》2012年第8期1496-1500,共5页Chinese Journal of Tissue Engineering Research

基　　金：2009年海珠区科技计划(2009-Y-017);智能型原味人工肛门的研制;2009年广州市科技计划(2009Z1-E251);智能型原味人工肛门的研制;2009年广东省科技计划(2009A030200014);智能型纳米复合材料原位人工肛门的研制;2010年广东省产学研结合项目(2010B090400423);抗菌性有机会相交人工肛门封堵器的研制与开发~~

摘　　要：背景：人工肛门封堵器塞体直径过大时对造口周围组织压迫严重,易引起缺血、坏死、感染等并发症,直径过小时,容易发生造口泄漏。目的：观察不同直径人工肛门封堵器的封堵效果,探讨人工肛门封堵器的最佳直径范围。方法：建立西藏小型猪直径约3.0cm结肠造口模型后,随机分为3组,分别植入直径3.0,3.5,4.0cm人工硅橡胶封堵器。结果与结论：封堵后第1周3.5,4.0cm组造口泄漏率低于3.0cm组（P〈0.05）,第4,8周时4.0cm组低于3.0cm组（P〈0.05,P〈0.05）,整体上泄漏率随直径增加有下降趋势,但各组第4,8周比较无明显差异。封堵后第4周3.5,4.0cm组中性粒细胞计数高于3.0cm组（P〈0.01）。封堵后第4,8周4.0cm组淋巴细胞计数高于3.0cm组（P〈0.05或0.01）。3.0cm组在第50s时肠管血流灌注量与基线水平比较差异有显著性意义（P〈0.05）,3.5和4.0cm组各时间点血流量与基线水平比较差异有非常显著性意义（P〈0.01）。说明在保证泄漏不严重的情况下,人工硅橡胶肛门封堵器直径比造口直径大0.5~1.0cm时可达到最佳封堵效果和最少并发症。BACKGROUND： Large diameter of the artificial closure device may result in ischema, necrosis and infection because of its severe oppression on tissue around the stoma, while small diameter of the artificial closure device may lead to leakage of the stoma. OBJECTIVE： To observe the occlusion effects of closure devices with different diameters so as to explore the most appropriate diameter. METHODS： Colostomy models with diameter of 3.0 cm were prepared in Tibet mini pigs and divided into three groups randomly. The three groups were implanted by artificial silicone rubber closure devices with diameters of 3.0 cm, 3.5 cm, and 4.0 cm respectively. RESULTS AND CONCLUSION： At 1 week after occlusion, the leakage rate of the 3.0 cm group was obviously higher than those of the 3.5 cm and 4.0 cm groups （P〈0.05）, the leakage rate of the 3.0 cm group was obviously higher than that of the 4.0 cm group （P〈0.05, P〈0.05） at 4 and 8 weeks. The leakage rate increased as the diameter increased, however, the leakage rate had no difference at 4 and 8 weeks. The lymphocyte count of the 4.0 cm group was higher than that of the 3.0 cm group at 4 and 8 weeks （P〈0.05, or P〈0.01）. The perfusion of the 3.0 cm group had significant difference with baseline level at 50 seconds （P〈0.05）, and the differences of the 3.5 cm and 4.0 cm groups were significant at each time point （P〈0.01）. The diameter of artificial silicone rubber closure devices 0.5-1.0 cm bigger than colostomy diameter may achieve the best effect of occlusion and least occlusion complication under the premise without severe leakage.

关 键 词：人工肛门封堵器 结肠造口 有机硅橡胶 造口并发症 激光多普勒 

分 类 号：R318[医药卫生—生物医学工程]