摘要
目的探讨游离空肠段肠腺分泌规律及其相应的病理学变化,为临床应用于气管重建提供依据。方法通过建立腹壁下去神经游离空肠的肠分泌动物实验模型,包括A组(无支架组)、B组(游离空肠联合镍钛合金内、外支架组)及C组(游离空肠联合镍钛合金外支架组),对比其术后肠分泌量的变化以及相应的病理学变化。结果①A、B、C三组术后早期肠分泌量增高,1月后肠分泌量显著减少并趋于稳定;B组和C组均比A组的分泌量大(P<0.05),1月后逐渐接近A组;B、C两组对比肠分泌量无显著差异(P>0.05);②移植空肠上皮腺体萎缩,肠黏膜上皮层变薄,微绒毛大部分脱落,部分吸收细胞空泡变性和坏死,杯状细胞减少;其中以B组改变最明显。结论去外源神经犬空肠段随着肠腺萎缩,肠腺分泌逐渐减少,术后60天左右趋于低水平;推断游离空肠重建气管是可行的。
OBJECTIVE To investigate the secretiveand histologic change of free jejunal flap. METHODS A ca-nine model of a 8 cm-segment of denervated jejunumpreserving its vascularization under the abdominal skin was established. Fifteen mongrel dogs were divided intogroup A (a single jejunal segment), group B(a jejunalsegment combined a Ni-Ti alloy intraluminal stent and“C” shape Ni-Ti alloy prosthesis placing outside it) andgroup C(a jejunal segment combined a“C”± shapeNi-Ti alloy prosthesis placing outside it ) randomly. The2-hours jejunal secretions of all dogs were gained at post-operative 1st day, 3rd day, 7th day , 15th day, 30th dayand 60th day. All specimens were prepared for light mi-croscope and transmission electron microscope exami-nations at 2 months postoperatively. RESULTS ① Thejejunal secretions were in higher level after operation anddecreased gradually in group A, B and C. One monthafter operation, the jejunal secretions in every group stoodin lower level. Between group B and A or group C and A,there were statistical differences (P< 0.05) in secre-tions at 7th to 60th days postoperatively. But, there wereno differences between group B and C(P > 0.05).② Injejunal segment, mucosal glands and mucosa were at-rophy . Microscopic study showed muscular and serouslayers with moderate inflammatory cells such as plasmacells infiltration. Transmission electron microscopic studyshowed evanescent intestinal microvilli, vacuolizationaldegeneration or necrosis in some absorptive cells and re-duction of goblet cells. These changes were significant in groupB. CONCLUSION The secretion of denervated segmentjejunum preserving its vascularization reduced gradually andstood in a lower level at 2 months postoperatively with theirmucosal glands atrophy. We think tracheal reconstruction withfree jejunal graft will be available.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2005年第5期323-326,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
广东省科技厅资助项目(2002C30406)
