CAJ | 학술논문

目的研究用带蒂空肠瓣修补实验犬局部缺损的胆总管,了解术后空肠瓣及胆管局部的病理变化及术后胆汁的pH值变化.方法将实验犬的胆总管部分切除,胆总管局部形成缺损,用带蒂空肠瓣修补胆管缺损.术中、术后测定胆汁的pH值,术后第6个月取活检行病理检查.结果实验犬术后生存6个月,此期间实验犬的生命体征无异常,体重增加.实验犬术前与术后第一天胆汁的pH值差异有统计学意义(P＜0.01).术后第一天引起胆汁的pH值增大.术前与术后第6个月胆汁的pH值的差异无统计学意义(P＞0.5).术后病理显示:吻合口愈合良好,胆管上皮的黏膜细胞与空肠黏膜上皮细胞排列整齐(10/10);但空肠瓣粘膜萎缩,胆管粘膜增生,有大量淋巴细胞、浆细胞及少量中性粒细胞浸润,未见多核巨细胞(10/10),淋巴细胞、浆细胞浸润(10/10),淋巴滤泡形成(3/10).结论用小面积的带蒂空肠瓣修补缺损的胆总管,能达到临床上的一期愈合.在术后6个月用于修补的空肠瓣能适应胆管局部的微环境,并保持胆汁pH值稳定.带蒂空肠瓣能用于胆管狭窄的修复手术.
목적 연구용대체공장판수보실험견국부결손적담총관,료해술후공장판급담관국부적병리변화급술후담즙적pH치변화.방법 장실험견적담총관부분절제,담총관국부형성결손,용대체공장판수보담관결손.술중、술후측정담즙적pH치,술후제6개월취활검행병리검사.결과 실험견술후생존6개월,차기간실험견적생명체정무이상,체중증가.실험견술전여술후제일천담즙적pH치차이유통계학의의(P＜0.01).술후제일천인기담즙적pH치증대.술전여술후제6개월담즙적pH치적차이무통계학의의(P＞0.5).술후병리현시:문합구유합량호,담관상피적점막세포여공장점막상피세포배렬정제(10/10);단공장판점막위축,담관점막증생,유대량림파세포、장세포급소량중성립세포침윤,미견다핵거세포(10/10),림파세포、장세포침윤(10/10),림파려포형성(3/10).결론 용소면적적대체공장판수보결손적담총관,능체도림상상적일기유합.재술후6개월용우수보적공장판능괄응담관국부적미배경,병보지담즙pH치은정.대체공장판능용우담관협착적수복수술.
Objective To study the physiologic and pathlogic alteration of the artificial bile duct generated by pedicled jejunum flap(CBD)in repairing local defect common bile duct of dog. Methods Common bile duct defected model was generated by partially cutting off CBDofdog.The pedicled jejunum flap with mesentery blood supply was created to repair the local defect CBD.The pH of bile was mcasuratcd during and post operation, the pathologic study was undertaken after 6 months.Results The experimental group live 6 months and the symptom and signs is abnormal after operation.The result of blood routine and biochemistry examination is no change(P＞0.05).The pH of postoperative bile decrease(P＜0.01).The pH of bile was changed remarkably 1 day after the pedicled jejunum flap replacement.But no significant changing in the following 6 months(P＞0.05).The postoperative pathologic study show:the anastomosis of experimental group healing well,and fiber tissue proliferates at the site of anastomosis,The Epithelium of the jejunum flap was atrophy and there were large quantity of lymphocytes,plasma cells and neutrophil within the jejunum flap(10/10).The epithelium of bile duct nearby the jejunum flap appears slight proliferate and infused with lymphocytes and plasma cells(10/10).There were lymphoid follicles in 3/10 cases.Conclusions The jejunum flap repairing bile duct healing well,but there was inflamatic change around the jejunum flap and nearby bile duct after the replacement.These observation suggested it is feasible to use the jejunum flap repairing the defected bile duct.The local physiology is stable without any changes in pH of bile acid.The alterative materials like umbilical ligment,blood vessel would be favorable in repair of defected bile duct.