磁力环治疗胃食管反流性疾病的实验研究  

Experimental study on treatment of gastroesophageal reflux disease with magnetic sphincter augmentation

作　　者：孙益峰[1] 杨煜[1] 张晓彬[1] 杨洋 叶波[1] 郭旭峰[1] 华荣[1] 茅腾[1] 李志刚[1] 

机构地区：[1]上海交通大学附属胸科医院胸外科上海交通大学食管疾病诊治中心,20030

出　　处：《中华胸部外科电子杂志》2018年第1期42-46,共5页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

摘　　要：目的胃食管反流性疾病(GERD)是指胃内容物反流入食管,磁括约肌增强器能够增加食管下括约肌(LES)张力达到抗反流的效果,该研究应用宁波胜杰康生物科技有限公司生产的磁括约肌增强器,验证该手术的安全性和有效性。方法 12例实验动物(猪)通过开腹或腹腔镜的方式放置磁力环于LES处,观察饲养1、3、6个月后实验动物的饮食行为、体重和手术前后LES压力的变化;通过钡剂造影观察进食通畅度、磁力环的扩张、闭合情况。解剖实验动物后,观察植入器械是否出现移位和腐蚀,是否有食管梗阻,以及是否出现植入区域食管组织炎症、糜烂和缺血坏死等。结果实验动物均能正常进食,3例偶有呕吐,3例进食较快有呕吐,三组实验动物体重均增加;吞钡显示钡剂通过顺畅,无明显近端食管扩张等阻碍吞咽的相关影像表现。LES测压提示术后压力较术前明显增加;大体标本显示磁力环固定于食管下段外膜附近,贴近肌层,形成纤维组织囊;10例标本磁珠附近组织镜下未见炎症细胞浸润,2例标本见少量—中等量中性粒细胞及少量淋巴细胞浸润。结论磁力环装置可通过开腹或腔镜方便植入,研究表明该装置以及安装技术安全、可靠,可转化到GERD患者中。Objective Gastroesophageal reflux disease is caused by gastric contents which reflux into the esophagus. Magnetic sphincter augmentation（MSA） can increase the tension of the lower esophageal sphincter （LES） to achieve anti reflux effect. The study uses the MSA produced by Ningbo Senscure Biotechnology Co., Ltd., and verify the safety and effectiveness of this operation. MethodsMSA device was implanted into the lower esophageal sphincter of 12 experimental animals （pigs） under surgical or laparoscopy. The changes of dietary behavior and body weight were observed for 1 month, 3 months and 6 months respectively.Changes of LES pressure and barium radiography which was used to observe feeding patency, expansion and closure of MSA were also measured and performed. The experimental animals were dissected, and observed whether there were displacement or corrosion of MSA, esophageal obstruction, esophageal inflammation, erosion and necrosis of the animals. ResultsThe experimental animals were able to eat normally, 3 cases of occasional vomiting, 3 cases of vomiting when eating fast, 3 cases with increased body weight. Barium radiography showed no significant proximal esophageal dilation and other factors that hinder swallowing.The average LES pressure after operation had a significant increase （P〈005）. The mucosa of the esophagus appeared normal in all cases, and there was no device migration. There was no significant tissue inflammation for 10 cases, and 2 cases were observed to have inflammatory cell infiltration under microscope. ConclusionsMSA can be easily implanted via laparotomy or laparoscopy. This study shows that the device and the mounting technique are safe and reliable, which can be applied to patients with gastroesophageal reflux disease.

关 键 词：胃食管反流性疾病 食管下括约肌 磁力环 

分 类 号：R571[医药卫生—消化系统]