用肺组织瓣重建胸段气管的动物实验与临床应用  

Clinical application and animal experiment of thoracic tracheal reconstruction by using pulmonary tissue flap

作　　者：石文君[1] 张苏宁[1] 杨伟[1] 赵俊刚[1] 赵洋[1] 刘军[1] 

机构地区：[1]中国医科大学第二临床学院胸外科,沈阳110004

出　　处：《中华外科杂志》2003年第3期218-221,共4页Chinese Journal of Surgery

基　　金：卫生部科研基金资助项目 ( 98- 1- 187)

摘　　要：目的　探讨用肺组织瓣重建胸段气管的可行性。　方法　健康犬 15只 ,切除其长 6～ 8个气管软骨环、周径 1/ 2以上的气管前、后壁 ,内置镍钛合金网架。游离邻近带血管蒂的肺组织瓣 ,缝合修补气管壁之缺损。分别于术后 2～ 12个月处死动物 ,观察气管缺损部位的修复情况 ,并取材行光学显微镜及电镜检察。临床上用此方法治疗 4例患者 ,其中 1例右主支气管因瘢痕狭窄闭锁 ,1例主气管下段混合瘤恶变 ,2例左主支气管类癌。　结果　实验犬呼吸道通畅、无狭窄及肉芽组织形成 ,用于修复的肺组织瓣和金属网架表面覆盖有较完整的假复层纤毛柱状上皮。临床治疗的 4例患者 ,均顺利恢复正常呼吸功能 ,随访疗效稳定。　结论　肺组织瓣是较理想的胸段气管重建材料。Objective To study the usability of pulmonary tissue flap in the reconstruction of the thoracic trachea. Methods Over half perimeter anterior and posterior wall and 6 to 8 tracheal cartilagious rings of dog trachea were resected. The nickel-titanium alloy mesh stent was placed inside the lumen for repair of the defect of the tracheal wall by nearby pulmonary tissue flap with the vascularized segment. The dogs were killed from 2 months to 12 months after operation. Specimens were taken and observed under light and electron microscope. Clinically, 4 patients were treated by this way operation [right common tracheal scarred stenosis and atresia(1), mixed cancerization in the lower part of the common trachea(1) and left common tracheal carcinoid(2)]. Results No stenosis and granulation tissue were observed in the prosthetic lumen, in which there was comparative continuous stratified ciliated columnar epithelium. All patients recovered respiratory function. Conclusion Pulmonary tissue flap is a promising prosthesis of thoracic tracheal reconstruction.

关 键 词：肺组织瓣 胸段气管重建 动物实验 临床应用 手术方法 

分 类 号：R655[医药卫生—外科学]