3D打印复合人工气管移植的实验研究  

Experimental study of 3D printing composite artificial trachea transplantation

作　　者：刘春全[1] 李华伟 蔡先启 贺迎 崔永[1] 

机构地区：[1]首都医科大学附属北京友谊医院胸外科,北京100050

出　　处：《临床和实验医学杂志》2018年第4期350-354,共5页Journal of Clinical and Experimental Medicine

基　　金：首都医科大学基础-临床科研合作基金(编号:16JL-L02)

摘　　要：目的构建三维(3D)打印复合人工气管,通过兔体内气管移植观察人工气管置换的效果。方法通过CT扫描兔气管三维重建结构,提取影像资料用3D打印技术制备聚乳酸羟基乙酸(PLGA)人工气管支架,以酶消化法分离得到兔肋软骨细胞并扩增,种植于3D打印的人工气管支架上培养,制备复合人工气管。取新西兰兔10只,体重约500 g,切除颈段气管2 cm,制备气管缺损动物模型。实验组(n=5)用复合人工气管与气管上、下端-端吻合;正常对照组(n=5)一期行自体气管端-端吻合术。术后观察动物存活情况,并于术后1、3、6个月行X线和CT观察,取材行大体观察、组织学观察;对实验组和对照组的感染率、吻合口裂开率、严重狭窄率、意外死亡率等进行比较。结果 10只新西兰兔顺利完成气管移植手术,术中无死亡。术后7只新西兰兔分别于64 d、96 d、108 d、118 d、125 d、127 d、148 d因呼吸困难死亡,其余3只新西兰兔均存活至6个月时处死,处死前无明显气促或呼吸困难,进食顺畅。兔总体存活64~182d,实验组平均存活158.0 d,对照组平均存活108.4 d,差异具有统计学意义(P<0.05)。实验组新西兰兔意外死亡1只、吻合口重度狭窄0只、吻合口裂开或感染2只,对照组新西兰兔意外死亡2只、吻合口重度狭窄1只、吻合口裂开或感染3只,实验组的意外死亡率(20.0%)、重度狭窄率(0)、吻合口裂开或感染率(40.0%)均低于对照组(40.0%,20.0%,60.0%),差异均有显著性(P<0.05)。结论 3D打印复合人工气管可以短期替代自体气管重建兔气道,吻合口狭窄、感染等为人工气管移植后的主要并发症。Objective To construct 3 D printing composite artificial trachea and observe the effect of tracheal transplantation in rabbits.Methods The three-dimensional reconstruction structure of rabbit trachea was scanned by CT using 3 D printing technique to prepare polylactic acid hydroxy acetic acid（ PLGA） artificial tracheal stent,the rabbit costal chondrocytes were isolated and amplified by enzymatic digestion or tissue culture,and cultured in 3 D-printed artificial tracheal stent,the composite artificial trachea was prepared. An animal model of tracheal defect was prepared by 10 New Zealand white rabbits,weighing about 500 g,and 2 cm of cervical trachea. In the experimental group（ n = 5）,the composite artificial trachea was anastomosed with the upper and lower end of the trachea,and the normal control group（ n = 5） underwent tracheal end-end anastomosis. The survival of animals was observed after operation,and X-ray and CT findings were observed at 1,3 and 6 months after operation,and the results were compared with those of the experimental group and control group,such as infection rate,stoma dehiscence,severe stenosis rate and accidental mortality. Results 10 New Zealand rabbits underwent tracheal transplantation successfully and there was no death case. After operation,only 7 New Zealand rabbits were died after 64,96,108,118,125,127,148 days respectively due to dyspnea. Among the anatomy,we can see 1 examples of anastomotic serious stenosis,2 cases of anastomotic infection with Dehiscence,the remaining 3 New Zealand rabbits survived to 6 months of execution. No obvious shortness or dyspnea was observed before execution and they ate smoothly. The total survival of rabbits was 64-182 days. The experimental group survived for 158. 0 days. The control group survives for 108. 4 days. The difference was statistically significant（ P 〈 0. 05）. New Zealand Rabbit in experimental group occurred accidental death 1,anastomotic severe stenosis 0,anastomotic opening or infection 2,control group of New Zealand R

关 键 词：兔 气管修复重建 3D打印 人工气管 

分 类 号：R318.1[医药卫生—生物医学工程]