肌瓣内置壳聚糖管修复颈段食管部分缺损的可行性研究

摘要

Objective To investigate the feasibility of muscle flap repairing partal cervical esophagus defect with inner chitosan tubular scaffolds.Methods A totoal of 21 rabbits were made partial cervical esophagus defect models, with inner chitosan tubular scaffolds set in breakage, extrinsic muscle flap repaired.Postoperative animal body weight change was ob-served.Three rabbits were sacrificed at 4,8 and 12 weeks later, respectively.Esophagus defect was observed under the na-ked eye and optical microscopy.Esophagus stenosis and peristalsis were observed by esophageal barium at 16 weeks later. Results There were 18 animals survived after operation.At the first four weeks, muscle flap tissues healed well, chitosan tube unabsorbed, with no inflammatory response was observed under light microscope.At eight weeks later, chitosan tube partially absorbed, muscle flap blood supply good, no fibrous tissue hyperplasia.At 12 weeks later, chitosan tube was com-pletely absorbed, inside muscle flap surface mucosal regeneration with no stenosis.At 16 weeks later, esophagus barium was found smooth without stenosis, and peristalsis was weak.Conclusions It was feasible that muscle flap repairing partal cervical esophagus defect with inner chitosan tubular scaffolds.%目的：探讨肌瓣内置壳聚糖管状支架补颈段食管部分缺损的可行性。方法取21只大耳白兔，制成颈段食管部分缺损模型，破损处内置壳聚糖管状支架，外附肌瓣修补。观察术后动物体质量变化；分别于术后第4、8、12周各处死动物3只，肉眼及光学显微镜下观察食管缺损修复情况；术后第16周行食管钡透，观察食管狭窄及蠕动情况。结果术后动物存活18只，第4周肌瓣组织愈合良好，壳聚糖管未吸收，光镜下见炎性反应；第8周聚糖管部分吸收，肌瓣血运良好，无纤维组织增生；第12周壳聚糖管完全吸收，肌瓣内表面黏膜再生，无管腔狭窄。术后第16周，钡透见食管通畅、无狭窄，蠕动弱。结论肌瓣内置壳聚糖管状支架修补颈段食管部分缺损具有可行性。