Dowidar N, Kolmos H J, Matzen P
Dept. of Medical and Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen, Denmark.
Scand J Gastroenterol. 1992;27(1):77-80. doi: 10.3109/00365529209011171.
The major problem facing patients treated with biliary endoprostheses is their frequent clogging, necessitating their exchange. Clogged endoprostheses contain mainly bacteria embedded in an amorphous proteinaceous material with the occasional presence of food fibres. We studied this problem in an in vitro model, evaluating the role of bacteria, endoprosthesis design, and material in sludge formation. We found endoprostheses perfused with artificially contaminated bile to contain significantly more sludge than those perfused with sterile bile (p less than 0.05). The amount of sludge varied with the bacterial species used. Endoprostheses perfused with bacteria producing beta-glucuronidase were not associated with a particularly large amount of sludge. Endoprostheses with side holes contained significantly more sludge than those without (p less than 0.05). Furthermore, endoprostheses made of material with a low friction coefficient, such as Teflon, contained significantly less sludge than endoprostheses made of materials with a higher friction coefficient, such as polyethylene and polyurethane (p less than 0.05). These results emphasize the role of bacteria in endoprostheses clogging and clearly demonstrate the harmful effect that side holes have on endoprosthesis function.
接受胆道内支架治疗的患者面临的主要问题是支架频繁堵塞，需要进行更换。堵塞的内支架主要包含嵌入无定形蛋白质物质中的细菌，偶尔还会有食物纤维。我们在体外模型中研究了这个问题，评估了细菌、内支架设计和材料在淤渣形成中的作用。我们发现，灌注人工污染胆汁的内支架比灌注无菌胆汁的内支架含有明显更多的淤渣（p小于0.05）。淤渣的量因所用细菌种类而异。灌注产生β-葡萄糖醛酸酶的细菌的内支架与特别大量的淤渣无关。有侧孔的内支架比没有侧孔的内支架含有明显更多的淤渣（p小于0.05）。此外，由低摩擦系数材料（如特氟龙）制成的内支架比由高摩擦系数材料（如聚乙烯和聚氨酯）制成的内支架含有明显更少的淤渣（p小于0.05）。这些结果强调了细菌在支架堵塞中的作用，并清楚地证明了侧孔对支架功能的有害影响。
