CAJ | 학술논문

目的探讨碳纤维增强碳基体复合材料(以下简称碳-碳复合材料)气管假体用于气管环形缺损修复的可行性.方法采用的实验动物为健康成年杂种犬8只.用于制作气管假体的碳-碳复合材料分为Ⅰ、Ⅱ两型,两者分别采用了不同的碳纤维编织方法.采用Ⅰ型或Ⅱ型碳-碳复合材料制备的气管假体各用于4只犬,切除犬颈段第2气管环下4个气管环长度的气管段,将长2 cm的管型假体分别与远近两个气管残端妥善吻合固定,其中采用对端吻合的1只,外套式吻合3只,内嵌式吻合4只.术后对犬的呼吸、进食及有无感染等状况进行观察.4个月后处死存活的实验动物,取出植入的碳-碳复合材料气管假体及其周围组织,进行组织病理学和扫描电镜检查.结果所有犬术后均有不同程度的咳喘症状,多持续1～4周便逐渐消失,2只外套式吻合犬有不同程度的进食障碍.最早采用对端吻合手术方式的1只实验犬因吻合部位断裂死于术后第3周;采用外套吻合方式的3只实验犬中2只因肉芽组织增生严重而窒息,分别死于第11、12周.1只外套式吻合与4只内嵌式吻合实验犬均正常存活,植入的气管假体4个月内位置无明显改变.假体为纤维结缔组织所包裹,Ⅰ型碳-碳复合材料气管假体与自身组织结合疏松;而Ⅱ型碳-碳复合材料气管假体与组织结合相对紧密,扫描电镜可见假体与组织间有纤维组织连接.假体内腔大部分腔面未见有上皮覆盖,仅假体两端可见有少量纤维组织长人,组织病理学检查示存在少量纤毛上皮.结论通过正确的手术吻合方法,碳-碳复合材料气管假体能够维持实验动物的呼吸道通气功能,吻合部位的肉芽组织增生和气管假体内腔上皮化等问题有待于进一步解决.
목적 탐토탄섬유증강탄기체복합재료(이하간칭탄-탄복합재료)기관가체용우기관배형결손수복적가행성.방법 채용적실험동물위건강성년잡충견8지.용우제작기관가체적탄-탄복합재료분위Ⅰ、Ⅱ량형,량자분별채용료불동적탄섬유편직방법.채용Ⅰ형혹Ⅱ형탄-탄복합재료제비적기관가체각용우4지견,절제견경단제2기관배하4개기관배장도적기관단,장장2 cm적관형가체분별여원근량개기관잔단타선문합고정,기중채용대단문합적1지,외투식문합3지,내감식문합4지.술후대견적호흡、진식급유무감염등상황진행관찰.4개월후처사존활적실험동물,취출식입적탄-탄복합재료기관가체급기주위조직,진행조직병이학화소묘전경검사.결과 소유견술후균유불동정도적해천증상,다지속1～4주편축점소실,2지외투식문합견유불동정도적진식장애.최조채용대단문합수술방식적1지실험견인문합부위단렬사우술후제3주;채용외투문합방식적3지실험견중2지인육아조직증생엄중이질식,분별사우제11、12주.1지외투식문합여4지내감식문합실험견균정상존활,식입적기관가체4개월내위치무명현개변.가체위섬유결체조직소포과,Ⅰ형탄-탄복합재료기관가체여자신조직결합소송;이Ⅱ형탄-탄복합재료기관가체여조직결합상대긴밀,소묘전경가견가체여조직간유섬유조직련접.가체내강대부분강면미견유상피복개,부가체량단가견유소량섬유조직장인,조직병이학검사시존재소량섬모상피.결론 통과정학적수술문합방법,탄-탄복합재료기관가체능구유지실험동물적호흡도통기공능,문합부위적육아조직증생화기관가체내강상피화등문제유대우진일보해결.
Objective The Carbon fiber reinforced carbon matrix composites were employed for reconstruction of large circumferential defect of the cervical trachea. The biocompatibility and biofunctionality of the new type carbonaceous tracheal prosthesis were evaluated, and the feasibility for cervical tracheal reconstruction discussed. Methods Two types of carbonaceous tracheal prosthesis with different weaving methods of carbon fiber were used on eight healthy canines. Three to six tracheal cartilage rings were resected circumferentially. The 2 cm long tracheal prosthesis was transplanted into canines and the anastomosis was completed by end-to-end, tracheal-into-prosthesis and prosthesis-into-tracheal method. The function of breathing, eating and infection was observed after surgery. Four months later, the five survival canines were sacrificed and the prosthesis with surrounding tissues was removed for observation by optical microscopy and scanning electron microscopy. Results All dogs had cough symptom in different degree lasted 1 -4 weeks after surgery. Two dogs with tracheal-into-prosthesis anastomosis showed eating disorders in different degree. One canine died due to airway obstruction caused by dislocation of prosthesis within three weeks after operation. Another two deaths in 11th week and 12th week were attributed to suffocation because of hypergranulation and scar formation. Prosthesis was surrounded by connective tissues and anchored firmly to the neighboring tissues. Most part of the luminal surface of tracheal prosthesis was not covered by respiratory mucosa. However, the inner layer showed scant re-epithelialization beyond the anastomosis.Conclusions The implantation of the carbonaceous tracheal prosthesis can maintain the normal respiratory function of the experimental canines, but hypergranulation and scar formation around the end of the tracheal prosthesis and repithelium on the luminal surface of the prosthesis are questions still remained to be solved.