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[肌肉瓣包裹法气管移植的研究]

[The investigation of tracheas transplantation by wrapping in a muscle flap].

作者信息

Wang Lian-zhao, Zhou Gang, Fan Fei, Zhang Feng, Li Bin-bin, Cai Guo-bin, Xue Fu-shan, Luan Jie, Zhou Chuan-de, Meng Fan-hui, Wnag Pei-tao, Wang Hua-bing

机构信息

Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing 100041, China.

出版信息

Zhonghua Zheng Xing Wai Ke Za Zhi. 2003 May;19(3):214-6.

Abstract

OBJECTIVE

To investigate the possibility of tracheas transplantation by wrapping it in a muscle flap.

METHODS

With a dog model, a number of tracheas were separately wrapped in the unilateral sternocephalic muscle flap and the bilateral sternohyoid-sternothyroid muscle flap, and placed in the original site. The tracheas autografting was used as a control. The viability was evaluated by the examination of fiberoptic bronchoscopy, histopathology and microangiography, the measurement of tracheal mucosal blood flow and the calculation of survival rate and percentage of patency.

RESULTS

The submucosal blood flow of the transplanted tracheas was detected in the unilateral sternocephalic muscle flap group and the bilateral sternohyoid-sternothyroid muscle flap group 1 week after the surgery and gradually reached the level close to the normal in 4 weeks, while the vascular ingrowth was also shown from the wrapped muscle flap into the transplanted tracheas by using a microangiography technique. The histopathological examination demonstrated that the structure of the transplanted tracheas was quite same as the original one and its inner surface was also covered with pseudostratified columnar ciliary epithelia. However, in the control group, the mucous membranes turned black one week after the transplantation and all dogs died from the graft necrosis.

CONCLUSION

The tracheas wrapped in a muscular flap could survive well for a long time.

摘要

目的

探讨用肌瓣包裹气管进行气管移植的可能性。

方法

以犬为模型,将多个气管分别用单侧胸头肌瓣和双侧胸骨舌骨肌-胸骨甲状肌瓣包裹,并置于原位。以气管自体移植作为对照。通过纤维支气管镜检查、组织病理学检查和微血管造影、测量气管黏膜血流以及计算存活率和通畅率来评估其存活情况。

结果

单侧胸头肌瓣组和双侧胸骨舌骨肌-胸骨甲状肌瓣组术后1周检测到移植气管黏膜下血流,4周时逐渐接近正常水平,同时通过微血管造影技术显示包裹的肌瓣有血管长入移植气管。组织病理学检查显示,移植气管的结构与原来的完全相同,其内表面也覆盖有假复层柱状纤毛上皮。然而,对照组移植后1周黏膜变黑,所有犬均死于移植物坏死。

结论

用肌瓣包裹的气管能长期良好存活。

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