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一种新的气道螺旋支架,旨在维持气道结构,在完全上皮化后可无创取出 - 在患有气管软化症的犬患者中的可行性和生存力研究。

A new airway spiral stent designed to maintain airway architecture with an atraumatic removal after full epithelization-Research of feasibility and viability in canine patients with tracheomalacia.

机构信息

Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.

Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain.

出版信息

Pediatr Pulmonol. 2020 Jul;55(7):1757-1764. doi: 10.1002/ppul.24816. Epub 2020 May 14.

Abstract

OBJECTIVE

Surgical management of tracheomalacia is a challenge, with current treatments still presenting numerous complications. In the field of veterinary medicine, this same pathology is present in a significant number of dogs. For this reason, we present an experimental clinical trial performed on canines with tracheobronchomalacia, using a new atraumatic removable tracheal spiral stent (SS). Both implantation procedure and clinical improvement have been analyzed in this study.

METHODS

In this study, four small dogs, a mean weight of 4.89 kg and body condition scores IV-V, were included. SS was implanted by two different surgical approaches. Image and clinical follow-up have been performed during 90 days. Symptoms were evaluated from 1 to 10 every week.

RESULTS

This study achieved 100% technical and clinical success. Median tracheal diameters were as follows: cervical 10.85 (3.3), inlet 7.75 (2.1), and carina 7.75 (1.9) mm, and length was 77.5 (26) mm. A 12 × 10 × 100-mm SS was implanted in all cases. Goose honk cough punctuation improved from 8 to 1; also, there were important changes in exercise intolerance, a mean weight loss of 8.76%. The values of modified Karnofsky scale varied from 50 (20) before surgery to 90 (10) after 30 days of surgery. Neither granuloma tissue nor fractures of the prosthesis was observed.

CONCLUSION

The results in dogs are promising, and a new therapeutic alternative seems to be available for veterinarian field. The similarity of this disease between dogs and newborns suggests that this SS design can also be useful for human trials.

摘要

目的

气管软化症的手术治疗具有挑战性,目前的治疗方法仍存在许多并发症。在兽医领域,大量的犬只存在同样的病理。出于这个原因,我们提出了一项针对犬气管支气管软化症的实验性临床试验,使用了一种新的无创伤可移动气管螺旋支架(SS)。本研究分析了植入程序和临床改善情况。

方法

本研究纳入了 4 只小型犬,平均体重为 4.89kg,体况评分为 IV-V 级。通过两种不同的手术方法植入 SS。在 90 天内进行了影像学和临床随访。每周对症状进行 1 到 10 的评估。

结果

本研究达到了 100%的技术和临床成功。气管的中位直径如下:颈部 10.85(3.3)mm、入口 7.75(2.1)mm 和隆突 7.75(1.9)mm,长度为 77.5(26)mm。所有病例均植入了 12×10×100mm 的 SS。鹅鸣咳嗽评分从 8 分改善到 1 分;同时,运动不耐受也有了重要的变化,平均体重减轻了 8.76%。改良卡诺夫斯基量表的数值从术前的 50(20)变化到术后 30 天的 90(10)。未观察到肉芽组织或假体骨折。

结论

狗的结果很有希望,为兽医领域提供了一种新的治疗选择。狗和新生儿之间的这种疾病的相似性表明,这种 SS 设计也可用于人体试验。

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