自制简易胆道支架修复兔胆道缺损的动物实验研究  

Repairment of bile duct defect with intraluminal stent in rabbits

作　　者：宫金伟 刘明[1] 董新舒[1] 刘春富[1] 

机构地区：[1]哈尔滨医科大学附属第四医院普外科,哈尔滨市150001

出　　处：《实用肝脏病杂志》2015年第3期282-285,共4页Journal of Practical Hepatology

基　　金：黑龙江省科技创新资助项目(GC09C407-4)

摘　　要：目的探讨支架法修复胆道缺损的可行性和安全性。方法采用医用静脉采血针制造简易胆道支架。将30只兔随机分为A组和B组,每组15只。在A组动物,切除胆总管0.5 cm;B组切除1.0 cm。应用自制简易胆道支架与缺损的胆总管断端进行捆绑,恢复其连续性。于术后1、3、6月各处死5只家兔,观察两组动物术后的生存情况、术前术后肝功能变化,肝脏、新生胆管组织和新生胆管组织病理学改变。结果两组均顺利完成手术,无术后黄疸发生。术后A组1只兔因胆漏死亡;B组1只因应激性溃疡死亡。A组动物术前ALT为(56.36±6.35)IU/L,术后1、3、6月分别为[(59.63±5.02)IU/L、(54.63±8.26)IU/L、(59.85±7.43)IU/L,P>0.05];AST为(54.13±7.63)IU/L,术后1、3、6月分别为[(57.42±8.31)IU/L、(55.42±5.21)IU/L、(53.62±5.61)IU/L,P>0.05];ALP为(207.35±63.47)IU/L,术后1、3、6月分别为[(218.42±73.23)IU/L、(195.31±46.73)IU/L、(189.31±37.64)IU/L,P>0.05];TBIL为(0.15±0.08)μmol/L,术后1、3、6月分别为[(0.17±0.04)μmol/L、(0.14±0.05)μmol/L、(0.16±0.07)μmol/L,P>0.05]。B组动物术前ALT为(60.26±3.65)IU/L,术后1、3、6月分别为[(69.21±5.13)IU/L、(63.79±8.35)IU/L、(59.97±6.47)IU/L,P>0.05];AST为(51.33±6.43)IU/L,术后1、3、6月分别为[(55.43±7.26)IU/L、(61.62±5.73)I U/L、(52.32±5.31)IU/L,P>0.05];ALP为(217.25±53.72)IU/L,术后1、3、6月分别为[(228.62±71.32)IU/L、(200.35±46.83)IU/L、(209.83±36.41)IU/L,P>0.05];TBIL为(0.14±0.05)μmol/L,术后1、3、6月分别为[(0.16±0.04)μmol/L、(0.12±0.02)μmol/L、(0.13±0.06)μmol/L,P>0.05];术后两组动物肝组织病理学与术前比较无显著变化;术后1月,两组支架已覆盖充血水肿的新生胆管组织;术后3月两组新生的胆管组织已无水肿存在;术后6月两组新生胆管组织在外观上与正常胆管组织无差异。结论本实验表明在血供丰富、缺损1.0 cm以内的胆总管具有很强的再生和形成新生胆管的能力。支架法修复1.0 cObjective To assess the feasibility and safety of repairing bile duct defect with intraluminal stent. Methods Thirty local rabbits were randomly divided into group A and B,with 15 in each. The common bile duct resection of 0.5 cm was underwent in group A and of 1.0 cm in group B. The self-made simple biliary stents were inserted to restore the continuity of the injured bile ducts. The liver function,postoperative survival,liver,bile duct and newborn bile duct were determined. The animals in two groups after 1,3,6 months were sacrificed. Results The operation in the two groups were successfully completed and no postoperative jaundice occurred. In group A,1 rabbit died because of bile leakage,and in group B,1 animal died because of stress gastrointestinal ulcer. The serum ALT levels was（56.36±6.35）IU/L,and 1,3 and 6 months after operation,they were[（59.63±5.02）IU/L,（54.63±8.26）IU/L,（59.85±7.43）IU/L,respectively,P〉0.05];AST was（54.13±7.63）IU/L,and1,3 and 6 months after,they were[（57.42±8.31）IU/L,（55.42±5.21）IU/L,（53.62±5.61）IU/L,respectively,P〉0.05];ALP was（207.35±63.47）IU/L,and 1,3 and 6 months after,they were [（218.42±73.23）IU/L,（195.31±46.73）IU/L,（189.31±37.64）IU/L,respectively,P〉0.05];TBIL was（0.15±0.08）μmol/L and 1,3 and 6 months after,they were[（0.17±0.04）μmol/L,（0.14±0.05）μmol/L,（0.16±0.07）μmol/L,respectively,P〉0.05]. In group B,serum ALT level was（60.26 ±3.65）I U/L,and 1,3 and 6months after,they were [（69.21±5.13）IU/L,（63.79±8.35）IU/L,（59.97 ±6.47）IU/L,respectively,P〉0.05];AST was（51.33±6.43）IU/L and 1,3 and 6 months after,they were [（55.43±7.26）IU/L,（61.62±5.73）IU/L,（52.32±5.31）IU/L,respectively,P〉0.05];ALP was（217.25±53.72）IU/L,and 1,3 and 6 months after,they were [（228.62±71.32）IU/L,（200.35±46.83）IU/L,（209.83±36.41）IU/L,respectively,P〉0.05];TBIL was（0.14±0.05）μmol/L,and 1,3 and 6 months after,they were [（0.16±0.04）μmol/L,（0.12±0.02）�

关 键 词：胆管损伤 胆道修复 胆道支架 免 

分 类 号：R657.4[医药卫生—外科学]