磁压榨技术联合内镜实施犬胃造瘘术  

Gastrostomy in dogs with magnetic compression technique combined with endoscopy

作　　者：严小鹏[1] 任冯刚[1] 刘雯雁[1] 董鼎辉[1] 张静[1] 张达[2] 白纪刚[1] 吕毅[1] 

机构地区：[1]西安交通大学第一附属医院肝胆外科陕西省再生医学与外科工程研究中心,西安710061 [2]西安市中心医院普通外科

出　　处：《中华胃肠外科杂志》2015年第8期832-834,共3页Chinese Journal of Gastrointestinal Surgery

基　　金：卫生部部属（管）医院临床学科重点项目（2010105）;中央高校基本科研业务费专项基金（XKJC2013003）;国家自然科学基金（51275387）

摘　　要：目的探讨在实验犬模型上利用磁压榨技术联合内镜操作实施胃造瘘术的可行性。方法磁压榨胃造瘘磁性装置包含一对带孔的圆柱状子磁体和母磁体。其中母磁体的孔内固定有14F胃管。健康雄性杂交犬4只，胃镜下将借助斑马导丝将子磁体送至犬胃体部，然后在犬左上腹切开皮肤并分离肌层至腹膜，将母磁体置于腹膜外，胃内子磁体和腹膜外母磁体自动相吸压榨胃壁和腹膜，利用穿刺针将夹在子磁体和母磁体之间的腹膜和胃壁反复穿刺打通，磁压榨胃造瘘术即完成。术后2周开腹观察瘘口形成情况并获取造瘘口标本。结果4只实验犬手术均获成功，手术时间为11-15 min。术后可快速通过胃造瘘建立肠内营养通道，造瘘管通畅性良好。术后2周开腹可见造瘘口胃壁与腹膜愈合良好，腹腔无粘连。结论磁压榨技术联合内镜实施胃造瘘操作简单、创伤小、安全性高，有望向临床推广。Objective To evaluate the feasibility of endoscopic gastrostomy combined with magnetic compression techniques in dogs. Methods The magnetic compression device consisted of a couple of cylindrical magnets with a hole in the center. A 14-French gastric tube was inserted through the hole and fixed on the parent magnets. Four male mongrel dogs were selected randomly for the operation. The daughter magnet was placed into the dog′s gastric body by a Zebra Guidewire under endoscopy, then a skin incision was performed on the left upper abdomen, through which the subcutaneous tissues and muscle were isolated up to the peritoneum. The parent magnet was placed on the surface of the peritoneum, which attracted the daughter magnet inside the gastric cavity automatically to compress the gastric wall and peritoneum. A needle was inserted through the gastric tube and punctured the tissue in the hole of the magnets repeatedly to form a fistula. After removing the needle, the gastrostomy was complete. The fistula was observed and its specimen was taken two weeks later under laparotomy. Results All the four operations were successfully performed, and the operation time was 11-15 minutes. The stoma was matured immediately, through which early enteral nutrition support was administered. The gastric wall and peritoneum were observed with well healing and no adhesion in the abdominal cavity under laparotomy two weeks after the operation. Conclusion The gastrostomy performed by magnetic compression technique combined with endoscopy is convenient , minimally invasive and safe, which may be used in future clinical practice.

关 键 词：磁压榨技术 内镜 胃造瘘术 动物模型 犬 

分 类 号：R656.6[医药卫生—外科学] R-332[医药卫生—临床医学]