用于胰十二指肠切除术中Braun吻合磁环的设计及临床应用  

Design and Clinical Application of Magnetic Rings Used for Braun Anastomotic in Pancreaticoduodenectomy

作　　者：张苗苗[1,2] 白纪刚 张东[1] 雷建军[1] 耿智敏[1] 冯爱芳[1] 董芳芳[1] 史爱华[2] 吕毅[1,2] 严小鹏[1,2] ZHANG Miaomiao;BAI Jigang;ZHANG Dong;LEI Jianjun;GENG Zhimin;FENG Aifang;DONG Fangfang;SHI Aihua;LV Yi;YAN Xiaopeng(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an Shaanxi 710061,China;National Local Joint Engineering Research Center for Precision Surgery&Regenerative Medicine,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an Shaanxi 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

出　　处：《中国医疗设备》2022年第6期8-11,共4页China Medical Devices

基　　金：陕西省重点研发计划一般项目(2021SF-163);陕西省创新能力支撑计划(2020KJXX-022);陕西省自然科学基础研究计划重点项目(2020JZ-37)。

摘　　要：目的设计用于胰十二指肠切除术中Braun吻合的磁环并进行临床试用。方法根据人体空肠解剖特点,结合胰十二指肠切除手术中Braun吻合需求,设计并加工了用于Braun吻合的子磁环(Daughter Magnetic Ring,DMR)和母磁环(Parent MagneticRing,PMR)。PMR为椭圆形位于输出袢肠管,DMR为圆形位于输入袢肠管。电子万能试验机测试DMR和PMR的磁力学性能。在临床中利用磁环为2例胰十二指肠切除手术患者实施Braun磁吻合,记录吻合操作时间、术后并发症及磁体排出时间。结果成功加工出用于Braun吻合的DMR和PMR。DMR和PMR在零距离时可获得最大吸力为44.60 N,随着位移增加,其间的吸力迅速减小。临床应用2例患者,吻合操作时间分别为2 min和1.5 min;术后患者未出现肠梗阻、肠瘘等并发症;磁体排出时间分别为21 d和25 d。结论利用磁环建立Braun吻合操作简单,临床初步试用显示安全可行,具有临床推广潜力。Objective To design the magnetic rings used for Braun anastomosis in pancreaticoduodenectomy and carry out clinical trial.Methods According to the anatomical characteristics of human jejunum and the needs of Braun anastomosis in pancreaticoduodenectomy,the daughter magnetic ring(DMR)and parent magnetic ring(PMR)used for Braun anastomosis were designed and manufactured.The PMR was oval and located in the efferent loop;the DMR was circular and located in the afferent loop.Magnetic properties of DMR and PMR were tested by electronic universal testing machine.Braun magnamosis was performed on 2 patients undergoing pancreaticoduodenectomy with magnetic rings.The operation time,postoperative complications and magnets discharge time were recorded.Results The DMR and PMR for Braun anastomosis were processed successfully.The maximum suction is 44.60 N at zero distance,and the suction between the DMR and PMR decreased rapidly with the increase of displacement.The operation time of anastomosis for the two patients was 2 min and 1.5 min respectively.There were no postoperative complications such as intestinal obstruction and intestinal fistula.The discharge time of magnets was 21 d and 25 d respectively.Conclusion Braun anastomosis using magnetic rings is simple to operate,and preliminary clinical trial shows that it is safe and feasible,which has the potential of clinical promotion.

关 键 词：磁外科 磁吻合 磁压榨技术 Braun吻合 胰十二指肠切除术 

分 类 号：R608[医药卫生—外科学]