自制分叉型人工气管重建犬气管及隆突对犬生存期及吻合口愈合的影响

目的：探讨应用自制复合材料的分叉型人工气管重建犬气管及隆突的可行性。方法：根据犬气管的生物力学指标选用碳纤维和硅橡胶自行设计制造一种新型的复合材料人工气管。选用19条健康成年犬随机分2组：A组(n=11)，人工气管直接与犬气管及支气管吻合；B组(n=8)，在人工气管与犬气管及支气管吻合的基础上，同时切开同侧膈肌，将带蒂大网膜从腹腔移植至胸腔包裹人工气管及吻合口，观察术后犬生存期及吻合口裂开情况。结果：术后平均生存期A组为(3.462±1.849)d，B组为(6.475±1.062)d，2组生存期比较差异具有显著性（P<0.05）；术后吻合口裂开A组发生率（37.5±36.0）%，B组（16.0±25.0）%，2组吻合口裂开发生率比较差异亦具有显著性（P<0.05）。结论：应用带蒂的大网膜移植包裹自制分叉型人工气管及吻合口可降低吻合口的裂开并延长实验犬的生存期，但防止人工气管移位及吻合口裂开仍然是该人工气管亟待解决的问题。

Effects of self-made carina type tracheal prosthesis on survival period and healing of anastomotic stoma in dogs

Objective To investigate the feasibility of using a new type carina type tracheal prosthesis made of complex material to replace trachea and carina defects. Methods According to biomechanics index, a new carina type tracheal prosthesis was designed and constituted with carbon fiber and silicon. 19 dogs were divided into two groups randomly: group A(n=11), the carina type tracheal prosthesis anastomosed directly to dog′s trachea and bronchus;group B(n=8), based on group A, meanwhile the diaphragm was incised and the pedicel caul was transplanted from abdominal cavity to thorax to enwrap the carina type tracheal prosthesis and anastomotic site. Results The average survival period post operation in group A and group B were (3.462±1.849)d and (6.475±1.062)d ,respectively. There was significant difference of the survival period between two groups(P<0.05). The anastomose dehiscence: group A was(37.5±36.0)% ; group B was(16.0±25.0)%, there was significant difference (P<0.05). Conclusion Using the pedicel caul to enwrap the carina type tracheal prosthesis and anastomotic site can reduce the degree of anastomose dehiscence and prolong the survival period of the experimental dogs, but how to prevent the prosthesis shift and anastomose dehiscence will be still a most question to be settled.