CAJ | 학술논문

目的探讨提高肺动脉移植物牛颈静脉带瓣管道(BJVC)机械性能的外支架方法.方法使用尼龙纤维编织人造纤维织物外支架.牛颈静脉管道经去除细胞成分后光氧化交联处理.按BJVC有、无外支架支撑分组进行体外实验比较机械性能和体内实验进行组织学观察.结果膨胀率的计算方法为测试管道在承受一定压力前后的变化率.有外支架组BJVC(实验组)在10～60mmHg(1 mm Hg=0.133 kPa)水压范围中的膨胀形变率最高在(11.4±3.1)%.而单纯的牛颈静脉(对照组)20 mm Hg时膨胀率即达(14.8±4.7)%.在30 mm Hg的逆行水压下实验组瓣膜反流量为0,而对照组同等压力下约32ml/min.渗漏方面,实验组在60mmHg时出现1ml/min的渗漏.而对照组在20、40、60mm Hg压力下渗出量分别为1、5、13 ml/min.两组比较差异均有统计学意义.9条犬接受牛颈静脉管道移植体内实验.6个月后组织学观察见实验组尼龙纤维周围炎性细胞浸润较密集,自体细胞浸润较快.结论外支架易制作,是完善牛颈静脉机械性能的一种较理想方法.
목적 탐토제고폐동맥이식물우경정맥대판관도(BJVC)궤계성능적외지가방법.방법 사용니룡섬유편직인조섬유직물외지가.우경정맥관도경거제세포성분후광양화교련처리.안BJVC유、무외지가지탱분조진행체외실험비교궤계성능화체내실험진행조직학관찰.결과 팽창솔적계산방법위측시관도재승수일정압력전후적변화솔.유외지가조BJVC(실험조)재10～60mmHg(1 mm Hg=0.133 kPa)수압범위중적팽창형변솔최고재(11.4±3.1)%.이단순적우경정맥(대조조)20 mm Hg시팽창솔즉체(14.8±4.7)%.재30 mm Hg적역행수압하실험조판막반류량위0,이대조조동등압력하약32ml/min.삼루방면,실험조재60mmHg시출현1ml/min적삼루.이대조조재20、40、60mm Hg압력하삼출량분별위1、5、13 ml/min.량조비교차이균유통계학의의.9조견접수우경정맥관도이식체내실험.6개월후조직학관찰견실험조니룡섬유주위염성세포침윤교밀집,자체세포침윤교쾌.결론 외지가역제작,시완선우경정맥궤계성능적일충교이상방법.
Objective To increase the mechanic characteristic of bovine jugular veins conduit (BJVC) by combined knitted stent outside made of nylon fiber. Methods Get rid of the cells of BJVC by enzymolysis, then combined a fabric stent with a acellular bovine jugular vein conduit that cross-linked dealed by photooxidation method to improve the mechanic function of BJVC. To compare the mechanical function and histology change of BJVC combined with fiber stent outside with that of BJVC only without stent. BJVC combined with fiber stent outside was divided into experiment group and the latter into control group. Two roller pumps on cardiopulmonary bypass unit were designed to simulate the pulmonary circulation. One produce the stream, and the other assist to bring a certain pressure by regulating a degree of tightness. The pressure of forward stream was used in messuring extension rate and leakage volume of two BJVC groups, and the pressure of backward stream was used in messuring the regurgitation volume. Results Set the formula to calculate the rate of variation of BJVC diameter under a certain pressure or not. The experiment group extension rate was zero under pressure of 10-20 mm Hg, about ( 7.7 ± 2.3 ) % under pressure of 40 mm Hg, until 60 mm Hg to ( 11.4 ± 3.1 ) %. While the control group reached about ( 14.8 ± 4.7 ) % at 20mm Hg already. There was no regurgitation volume of the experiment group under pressure of 30 mm Hg vs. the control group' s reached 34ml/min at 30 mm Hg while the two groups were same under pressure that lower than 20 mm Hg. When the pressure higher, the difference between the two groups more notable. There was no leakage of the BJVCs with fabric stent till pressure from 40 mmHg to 60mmHg, vs. the control group 1,5, 13 ml/min at pressure 30, 40, 60 mm Hg. Except the regurgitation and leakage volumes under pressure at 10 -20 mm Hg, as the two numerical values were both zero that can not be caculated by the statistic software, the differences of the two groups above had statistics significance. In vivo, 9 dogs received bovine jugular vein conduit transplant procedure to observe the mechanic fnction and tissue reaction. Five adopted B.JVC with stent and four just BJVC only. Six month later after the transplant procedure, there was no significant difference between the two groups but more inflaming cells than the former group, especially at the location round the nylon fibers. Through the observation in HE stain, that was considered as foreign body reaction. Conclusion Fabric stent can improve the mechanical function of BJVC and relatively easy to get.