碳纤维人工食管用于牛羊的实验研究

选用碳纤维作为食管代替物,对各切除颈段固有食管3～4cm的8例绵羊和2例犊牛行食管植入吻合术。植入的碳纤维人工食管长度为3～4.5cm,管径为1～2cm,管壁厚为0.1～0.15cm。人工食管与食管断端采用作者改进的高桥氏二层重叠缝合方法吻合。术后除2例绵羊因人工食管渗漏子第4d死亡外,其余吻合手术均获成功。绵羊术后4～5d采食咀嚼碎青草自如,但咽下较缓慢,有时反复2～3次方能咽下;术后5～20d,采食及吞咽恢复至正常状态;20d后又复出现吞咽缓慢。犊牛术后饮奶咽下顺利,到20d后偶有反复吞咽和奶汁由鼻孔中返流现象,经3～5d恢复正常。经X线透视或钡剂食管造影检查,术后7～14d,钡液顺利通过食管和人工食管,显示人工食管部较正常食管稍细,术后22～26d,人工食管脱落,脱落部食管狭窄,其前方食管呈纺锤状扩张。动物全身及血液,生化指标观察均无明显改变。病理学观察,术后15d可见在食管两断端由新生肉芽组织形成纤维膜管以包裹人工食管,在新生肉芽组织纤维膜管内面,靠近食管吻合口边缘,已长出灰白色薄层粘膜;术后22～25d,人工食管脱落于瘤胃或网胃中,食管缺损段已由新生的食管组织连接在一起,新生食管外周形成纤维膜包裹,管腔内面被覆有较完整的薄层粘膜;术后35～40d。见新生食管内面粘膜层覆盖完整,管壁稍增厚,内腔稍

EXPERIMENTAL STUDY ON THE ESOPHAGEAL REPLACEMENT WITH CARBON-FIBRE TUBE IN CALVES AND SHEEP

Cervical esophagus was anastomosed with carbon-fibre tube as replacement in 8 sheep and 2 calves. After right-side position restraint and general anaesthesia, the esophagus was resected by 3.0-4.0 cm, and then the carbon-fibre tube, 3.0-4.5 cm long, 1.0-1.2 cm in diameter, with thichness of 0.1-0.15 cm was implanted. The ends of esophagus and artificial tube were sutured by modified Takashashi Method. All of the test animals survived except 2 sheep died of leakage 4 days after operation. The study confirmed that carbon-fibre tube is convenient for the passage of food, and favorable to the repair of the wounded esophagus. The carbon-fibre is nontoxic, histocompatible and does not produce remarkable stimulation to the tissues, and could be considered as the best artificial repairing material up to date, The repair of the wounded esophagus is completed only after connective tissue filled up the surgical wounds with the covering of fibrous membranes and the artificial tube falled off naturally. In this study the falling of the tube happened in 24-26 days.