基于磁压榨技术的无创化胃造瘘的大鼠模型研究  

Noninvasive gastrostomy based on magnetic compression technique:an experimental study in rat models

作　　者：张苗苗[1,2] 吉琳 盖敬慈 雷凤萍 刘培楠 王伊睿 蓝婷 张涵芷 李恒 吕毅 严小鹏[1,2] ZHANG Miaomiao;JI Lin;GAI Jingci;LEI Fengping;LIU Peinan;WANG Yirui;LAN Ting;ZHANG Hanzhi;LI Heng;LU Yi;YAN Xiaopeng(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;National Local Joint Engineering Research Center for Precision Surgery&Regenerative Medicine,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Qide College,Xi'an Jiaotong University,Xi'an 710061,China;Zonglian College,Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,陕西西安710061 [2]西安交通大学第一附属医院精准外科与再生医学国家地方联合工程研究中心,陕西西安710061 [3]西安交通大学启德书院,陕西西安710061 [4]西安交通大学宗濂书院,陕西西安710061

出　　处：《中国普通外科杂志》2021年第10期1175-1183,共9页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(81700545);陕西省创新能力支撑计划资助项目(2020KJXX-022);陕西省重点研发计划资助项目(2021SF-163);陕西省西安交通大学大学生创新训练项目(S202110698414)。

摘　　要：背景与目的:胃造瘘术是普通外科常见手术,传统胃造瘘术创伤大,已逐步被内镜下胃造瘘、X线下胃造瘘术取代,但实施过程需要内镜系统或X线机辅助,且操作较为繁琐。基于应用磁压榨技术行无创化胃造瘘的设想,本研究采用自行设计加工的胃造瘘磁体装置,在大鼠模型上验证该设想的可行性和安全性。方法:根据大鼠消化道解剖特点和尺寸自行设计加工适合于大鼠胃造瘘的钕铁硼子母磁体,电子万能试验机测试子母磁体的磁力学曲线。10只SD大鼠麻醉后经口置入子磁体至胃内,在大鼠左上腹部放置母磁体,子母磁体自动吸合,腹部X线明确磁体相吸情况。术后单笼饲养,观察大鼠存活状况、磁体脱落时间、磁体留置期间并发症发生情况。术后2周处死动物,获取造瘘口标本,肉眼及光镜下观察造瘘口形成情况。结果:设计和生产出的子母磁体均为圆柱状,采用N42烧结钕铁硼加工而成,表面电镀镍防护处理。子磁体直径5 mm、高3 mm,母磁体直径6 mm、高5 mm,子母磁体质量分别为0.410 g和1.035 g。子母磁体在零距离时最大吸力达4.36 N,磁体吸力随位移增加而逐渐减小。10只大鼠麻醉后均成功经口置入子磁体至胃内,在大鼠左上腹部放置母磁体后,子母磁体迅速相吸,腹部X线检查显示磁体对位吸合良好。术后大鼠均存活,子母磁体留置期间,未出现磁体移位、子母磁体分离等意外事件,所有实验动物无消化道梗阻、腹腔感染等并发症。术后10~13 d子母磁体脱落,胃造瘘通道建立。术后2周开腹观察可见造瘘口处胃壁和腹壁粘连愈合牢固,腹腔无渗液及粘连。获取造瘘口标本肉眼可见瘘口形成良好,HE及Masson染色光镜下观察可见瘘口组织结构层次清晰。结论:基于磁压榨技术的胃造瘘磁体设计巧妙、易于加工、成本低,该方法建立无创化大鼠胃造瘘操作简单,安全可行,造瘘口各层组织愈�Background and Aims:Gastrostomy is a common operation in general surgery.Traditional gastrostomy has been gradually replaced by endoscopic gastrostomy and X-ray gastrostomy due to the great surgical trauma.However,the implementation process requires the assistance of endoscopic system or X-ray machine,and the procedure is complicated.Based on the assumption of performing a noninvasive gastrostomy by magnetic compression technique,this study was conducted to verify the feasibility and safety of this assumption in rat models using a self-designed and developed magnet device for gastrostomy.Methods:According to the anatomical characteristics and size of rat digestive tract,the parent and daughter magnets made from Ndfeb and suitable for rat gastrostomy were designed and produced.The magnitude of the magnetic force between the parent and daughter magnets was tested by electronic universal testing machine.In 10 SD rats,the daughter magnet was inserted into the stomach through mouth after anesthesia and the parent magnet was placed in the left upper abdomen.After the two magnets automatically latched onto each other,the attraction status was confirmed by abdominal X-ray.After operation,the rats were raised in a single cage,the survival status,time of magnet detachment,and complications during magnets retention were observed.The animals were sacrificed 2 weeks after the operation,and the gastrostomy specimens were obtained to observe the formation of the gastrostomy under naked eye and light microscope.Results:Both the self-designed and produced parent and daughter magnets were cylindrical shaped and made from N42 sintered Ndfeb,with nickel plating on the surface.The diameter and height of the daughter magnet were 5 mm and 3 mm,and the diameter of the parent magnet were 6 mm and 5 mm,respectively.The mass of the daughter magnet and parent magnet were 0.410 g and 1.035 g respectively.The maximum adhesive force of the parent and daughter magnets was 4.36 N in direct contact,and the magnetic force of the magnets decreased

关 键 词：胃造口术 磁力学 磁压榨技术 大鼠 

分 类 号：R656.6[医药卫生—外科学]