| 林爱军,郭启勇,卢再鸣,廖伟,刘兆玉.正常犬气管内高位留置支架的实验研究[J].中国医学影像技术,2006,22(8):1151~1154 |
| 正常犬气管内高位留置支架的实验研究 |
| Self-expanding metallic stents placement in the upper trachea: an experimental study in dogs |
| 投稿时间：2006-04-05 修订日期：2006-08-08 |
| DOI： |
| 中文关键词: 气管狭窄 支架 实验 犬 |
| 英文关键词:Tracheal stenosis Stent Experiment Dog |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨气管内高位留置支架的安全性及影响因素。方法 24只实验犬平均分为3组,气管内高位留置支架。A组:支架上缘平声门下缘,B组:支架上缘在声门下5 mm,C组:支架上缘在声门下15 mm。术后观察实验犬有无呼吸困难、咳嗽、喘息、呼吸急促,有无吞咽困难和发声困难。术后1周、1个月、3个月、6个月各组分别处死2只实验犬,处死前螺旋CT检查,观察支架移位情况。观察标本病理改变,比较不同时间增生组织厚度,并进行方差分析。结果 实验犬均无急性呼吸、吞咽或发声困难发生,均有轻、中度咳嗽,3~5天后缓解。A组1只犬术后5天因持续腹泻死亡,C组1只犬术后21天死亡,尸检未见喉、气管及食管异常。各组实验犬术后发声和进食正常。8只犬(A组3只,B组2只,C组3只)术后8~12周左右出现喘鸣、呼吸费力, CT提示气管腔狭窄,其中5只在3个月时处死,另3只继续饲养,呼吸困难、喘鸣6个月逐渐缓解。复查时支架均有向下移位,各组移位距离无统计学差异(P>0.05),1周、1个月、3个月、6个月时移位距离无统计学差异(P>0.05)。支架留置后不同时间组织增生厚度存在明显差异(P<0.05),1周、1个月、3个月、6个月时增生组织厚度分别为(0.84±0.21)mm、(1.26±0.33)mm、(8.61±1.73)mm、 (2.58±0.87)mm。3个月时增生厚度大于1周、1个月、6个月时增生厚度(P<0.05)。结论 ①声门下气管内留置支架是安全的,不会引起急性呼吸困难和窒息,不影响进食和发声功能;②气管内高位留置支架容易发生轻度下移,支架移位发生于1周内,1周后支架位置相对稳定;③支架留置后3个月内组织增生随时间增长而逐渐加重, 6个月时有减轻趋势。 |
| 英文摘要: |
| Objective To evaluate the security and the correlative factors of the stents placement in the upper trachea. Methods Twenty-four dogs were defined three groups, each group includes eight dogs. Under the guidance of fluoroscopy, self-expanding metallic stents (SEMS, 20 mm in diameter and 50 mm in length) were deployed in the upper tracheal at the predetermined level. Group A: proximal margin of the stent at the level of the lower margin of glottis. Group B: proximal margin of the stent at the level of 5 mm below the lower margin of glottis. Group C: proximal margin of the stent at the level of 15 mm below the lower margin of glottis. All the dogs were monitored daily for whether have the sign of respiratory distress, coughing, stridor, tachypnea and dysphagia or dysphonia. By the time of one week, one month, three months and six months after operation, two dogs in each group were examined by CT to evaluate migration of the stents, and then killed for pathologic examination. The thickness of hyperplasia tissue at different time, different parts were measured and compared. Results After the stent placement, all dogs had a cough, which alleviated three to five days later. All dogs did not have dyspnea, dysphagia or dysphonia. One dog in group A died of diarrhea five days after the stent placement and one dog in group C died of accident. Eight dogs underwent stridor or dyspnea from eight to twelve weeks after the operation, CT examination indicated that there were serious stenosis in tracheal lumen, five dogs were killed at the time of three months, the symptom of the other three dogs alleviated when observed to six months. All stent migrated downwards slightly, there were no statistical difference in migration distance between each group(P>0.05), the mean migrated distance was (9.86±5.27) mm. There were no statistical difference in the thickness of hyperplasia tissue between each group(P>0.05). The mean thickness of hyperplasia tissue was (0.84±0.21) mm, (1.26±0.33) mm, (8.61±1.73) mm, (2.58±0.87) mm at one week, one months, three months and six months respectively. There were statistical difference in the thickness of hyperplasia tissue between different time(P<0.05). At the time of three months, granulation tissue was obvious, excessive hyperplasia tissue formation was observed at the lumen of the stent. It does not occur to such a degree by the time of six months. Conclusion It is safe to deploy SEMS in the upper trachea, which migrate downwards slightly, the migration occurred within one week. Hyperplasia tissue gradually become serious within three months and mitigate by the time of six months. |
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