胆管损伤早期内置支架并Ⅰ期修复的实验研究

目的探讨胆管损伤早期内置支架并Ⅰ期修复对术后远期胆管狭窄的预防作用及其临床应用价值。方法用36只日本大耳白兔建立胆管损伤模型，将其分为三组，A组：内置支架并Ⅰ期修复组（n=12），B组：支架拔除组（n=12），C组：单--Ⅰ期修复组（n=12）。观察手术后不同时间点各组动物血碱性磷酸酶、转氨酶及胆管壁胶原含量变化情况，并对胆管壁进行HE及Masson染色做病理学检查。结果C组在术后各时间点血碱性磷酸酶、转氨酶及胶原含量均与A组差异有统计学意义（P〈0．05）；B组术后2个月时上述指标与A组差异有统计学意义（P〈0．05）；术后4个月时差异无统计学意义（P〉0．05）。结论胆管损伤早期内置支架并Ⅰ期修复具有预防术后远期胆管狭窄的作用，但过早拔除支架可能会导致狭窄的发生。

Experimental study of early placing stent in common bile duct and primary repair after common bile duct injury

Objective To explore the preventive effect of early placing stent in common bile duct(CBD) and primary repair after common bile duct injury on the long-term stricture of bile duct postoperation and its clinical value.Methods In an animal model,36 Japanese rabbits underwent simulated common bile duct injuries and then randomly divided into 3 groups: group A,stent inserted in CBD with primary repair(n=12);group B,stent extracted from CBD(n=12),and group C,primary repair only(n=12).The changes in alkaline phos...