食管支架的动物实验研究  

Experimental Study of Esophageal Metallic Stent in Rabbits

作　　者：狄镇海[1] 王永忠[2] 王晓川[1] 沈沛 李麟荪[4] 

机构地区：[1]江苏大学附属医院介入放射科 [2]江苏大学医学院病理解剖学教研室,江苏镇江212001 [3]常州市智业医疗仪器研究所,江苏常州213000 [4]南京医科大学附属医院介入放射科,江苏南京210000

出　　处：《江苏大学学报（医学版）》2002年第4期331-332,共2页Journal of Jiangsu University：Medicine Edition

摘　　要：目的 :观察兔食管在置入金属支架后的病理变化并对临床应用提出建议。方法 :对 8只健康家兔食管内置入镍钛合金网状支架 ,分别于置入后 2、4、6、8w造影、处死进行肉眼和光学显微镜观察。结果 :内支架置入 1w时可见黏膜下灶性慢性炎症伴轻度水肿 ;4w食管近支架上下两端处轻度狭窄 ,可见小息肉样赘生物为灶性慢性炎症伴炎性增生 ,支架口部黏膜过度增生 ,向腔内突起 ;6w时与 4w时比较 ,以上改变有不同程度加重 ,其中 1例支架下端一侧嵌入食管壁使其局部增生 ,与主动脉粘连 ;8w组于 7w末死于支架处食物团滞留梗阻。结论 :食管内支架再发狭窄的部位似乎以食管近支架上下的两端为主。为了防止再狭窄 ,支架两端口部的管径、形状、性状有待于进一步改进 ;支架段食管无蠕动 ,如无重力作用 ,食物易在其内滞留梗阻 ,因此 ,对良性食管狭窄的临床应用应谨慎。Objective:To analyze the reaction in rabbit's esophagus after inserting a metallic nitinal stent and to get suggestions for the clinical application. Methods:The self expanding nitinal stent was placed in each of eight rabbits' esophagi. The rabbits were killed 2, 4, 6, and 8 weeks after implantation. Tissue around the stent was observed with naked eye and microscopy. Results:Chronic inflammation and edema were seen in submucous tissue 1 week after stenting. Slight stenosis occurred at the regions of two ends of stent and scattered vegetation like polyp were seen with naked eye in 4 weeks, and inflammatory cell infiltration, partial mucous polypoid hyperplasia were seen under microscopy. The pathological changes were more obvious in 6 weeks compared with in 4 weeks. The lower end of one stent was embedded in esophageal wall. Two rabbits of 8 weeks' group were died of obstruction because the food tarried in stents. Conclusions:The restructures after stenting were mainly seen at the regions of two ends of the stent. To prevent restructure the form and quality of two ends of the stent should be reformed. The section at the stent shows no peristalsis. Because of the high restenosis rate, stent implantation in benign esophageal stricture should be undertaken with care.

关 键 词：动物实验 金属支架 镍钛合金网状支架 食管狭窄 食管内支架植入术 食管再狭窄 

分 类 号：R655.4[医药卫生—外科学] R－332[医药卫生—临床医学]