犬自体肋软骨膜构建的气管假体行气管移植重建

目的：探讨犬自体肋软骨膜构建的气管假体进行气管移植重建的可行性。方法：实验犬10条，以其自体肋软骨膜包绕特制的硅胶棒制成管状物，埋植到气管旁肌肉组织内，建立血运，4周后，除去硅胶棒制成气管假体进行气管移植重建。通过观察实验犬移植术后的存活情况，移植后8周的大体标本检查以及病理学检查，评价假体置换的效果。结果：8条存活的实验犬移植术后呼吸道通畅，饮食活动与正常犬无差别；构建的气管假体与气管旁肌肉组织紧密愈合，血运丰富，吻合口处愈合良好，无肉芽组织及瘢痕形成；管腔内表面光滑，表面有一层白色的黏膜覆盖。在普通光学显微镜下，可见气管假体的吻合口两端及吻合口处有气管黏膜生长，其内表面被覆无明显纤毛存在的假复层柱状上皮；其外层为成纤维细胞和纤维组织，其间散在少量炎性细胞；在纤维膜下可见新生软骨细胞，数量较少，软骨细胞的胞浆着色较淡，表明软骨细胞为新生的；其外层可见横纹肌细胞，其间有大量的新生的直径不等的微血管和毛细血管，软骨细胞与肌细胞之间连接紧密。结论:应用犬自体肋软骨膜构建的气管假体进行犬气管的移植重建具有可行性。

Reconstruction of dog trachea using prosthesis constructed with autogenous costal perichondrium

Objective To study the feasibility of reconstructing trachea by implanting autogenous costal perichondrium tracheal prosthesis.Methods Ten dogs were used.Three pieces of costal perichondrium of every dog were wrapped on a silicon bar used as skeleton and implanted into sternohyoid muscle adjacent to trachea to establish blood supply.Four weeks later,silicon bar was removed and perichondrium ring served as tracheal prosthesis.Trachea resection and prosthesis replacement was performed.Viability of dogs,gross and microscopic pathological changes were studied to evaluate the effect of prosthesis replacement.Results The respiratory tracts of the 8 survival dogs were not obstructed.Their diet,activity and bark were not different from those of the normal dogs.With abundant blood supply,the prosthesis fused tightly with the surrounding tissue.Anastomotic orifice healed without cicatricial tissue and granulation tissue.The internal surfaces of prosthesis were smooth and glossy with white tunica mucosa covered.Under light microscope,internal surfaces of prosthesis were found covered by pseudostratified columnar epithelium with few cilia.Under tracheal mucous membrane,there were fibrous membrane,neonate chondrocytes and striated muscle cells stratum successively.Fibrous membrane was composed of collagen and fibroblasts with a few inflammatory cells scattered.A small number of neonate chondrocytes were found under fiber membrane.Plasma of these chondrocytes looked pale after staining,which indicated that these chondrocytes were neonate.Striated muscle cells connected with the neonate chondrocytes firmly. Neonate capillaries and micro blood vessels of various diameters were abundant in striated muscle stratum.Conclusion It is feasible to reconstruct dog trachea using prosthesis constructed with autogenous costal perichondrium.