同种异体气管移植一例  

Tracheal transplantation

作　　者：何建行[1] 梁兆煜[2] 杨运有[1] 韦兵[1] 殷伟强[1] 温晓晖 曾仑[1] 钟南山[1] 

机构地区：[1]广州医学院笫一附属医院,510120 [2]佛山市第二人民医院

出　　处：《中华外科杂志》2000年第8期595-597,I033,共4页Chinese Journal of Surgery

基　　金：98广东省重点科技攻关项目!(980 688)

摘　　要：目的　利用同种异体气管移植治疗病变长度超过 5cm的气管疾病。　方法　 1999年 3月 17日为 1例喉癌复发患者行全喉和气管中上段切除 8cm ,供体气管长约 6cm ,经体外灭菌和除抗原处理 16 8h后 ,用 5 5cm一端与气管在隆突上 3cm处吻合 ,另一端与胸骨上皮肤及胸大肌皮瓣作吻合作气管外口。用带蒂胸大肌皮瓣和带蒂大网膜包裹供体气管解决血供。　结果　气管内吻合口生长良好 ,2 6d起供体气管内粘膜开始被自体气管内粘膜取代 ,6 5d复查证实同种异体气管生长良好 ,受体已接受供体 ,移植的气管己与受体气管共长为一体 ,受体气管粘膜已覆盖供体气管 ,比预想的提早了近 2 0d ,无排斥反应。患者术后 30d可带气管套管恢复生活自理 ,35d恢复晨操 ,6 5d可自行驾摩托车出院。　结论　同种异体气管移植治疗病变长度超过 5cm的气管疾病近期是可行的。Objective[WT5”BZ] To treat long tracheal cancer by tracheal transplantation. [WT5”HZ]Methods[WT5”BZ] In March 17,1999,a petient received a total laryngeal resection and a resection of 8 cm upper and middle trachea, which was replaced by a 6 cm long trachea of another donor. The donor trachea was dipped first in preservation liquid A for sterilization for 24 hours, then in preservation liquid B for over 48 hours for destructing MHC. Pedunculated greater omentum and pedunculated greater pectoral musculus supplied the blood for the donor trachea. One side of the donor was anastomosed with the lower trachea, and the other with the neck skin. [WT5”HZ]Results[WT5”BZ] The patient survived 300 days after operation. The auto tracheal membrane covered the donor surface; auto and xeno trachea was well anastomose. The new trachea grew very well. [WT5”HZ]Conclusion[WT5”BZ] Trachea transplantation is possible the best method to treat long tracheal disease if the transplantative trachea is less 5 cm. [WT5”HZ]

关 键 词：同种异体气管移植 气管癌 气管狭窄 

分 类 号：R653[医药卫生—外科学]