CO2激光焊接辅以化学胶Ⅰ期修复犬内置可降解支架胆总管的可行性及全性

doi:国家自然科学基金资助课题（50373043）

CO₂激光焊接辅以化学胶Ⅰ期修复犬内置可降解支架胆总管的可行性及全性

刘铜军¹，姜伟¹，于惠秋²，景遐斌³，陈学思³，李建国^*，李鹏飞^*

1.吉林大学第一医院普通外科，吉林长春 130021；2.吉林大学中日联谊医院康复科，吉林长春 130033； 3.中国科学院长春应用化学研究所高分子物理与化学实验室，吉林长春 130033

收稿日期:2006-10-26 修回日期:1900-01-01 出版日期:2007-05-28 发布日期:2007-05-28
通讯作者: 于惠秋

Feasibility and safety of repairing dog common bile duct with laser welding assisted with chemical glue following placing degradable stent in it

LIU Tong-jun¹， JIANG Wei¹， YU Hui-qiu²，JING Xia-bin³，CHEN Xue-si³，LI Jan-guo^*，LI Peng-fei^*

1.Department of General Surgery，First Hospital，Jilin University，Changchun 130021,China; 2.Department of Rehabilitation,China-Japan Union Hospital,Jilin University，Changchun 130033，China; 3.Laboratory of Macromolecular Physics and Chemistry，Changchun Institute of Applied Chemistry of China Academy of Sciences,Changchun 130033,China

Received:2006-10-26 Revised:1900-01-01 Online:2007-05-28 Published:2007-05-28
Contact: YU Hui-qiu

摘要/Abstract

摘要： 目的：探讨应用CO₂激光焊接辅以化学胶I期修复内置可降解支架胆总管切口的可行性和安全性。方法：本地杂交犬63只行胆总管横行切开后，依据对切口I期修复方法不同随机均分为缝合组、CO₂激光组（简称激光组）、CO₂激光+化学胶组（简称激光＋胶组）。每组均在胆总管切口吻合前置入聚乳酸（PLA）可降解支架，测试并记录胆总管吻合时间、吻合口破裂压和外径的变化，光镜下观察吻合口病理学改变及电镜下观察内支架的外形变化。结果：激光组和激光＋胶组胆总总管吻合时间均明显短于缝合组（P＜0.05）；术后1、4和12周时，吻合口破裂压缝合组与激光＋胶组比较差异均无显著性（P＞0.05），而激光组均低于前两组（P＜0.05）；术后4和12周时，激光组和激光＋胶组胆管吻合口外径较吻合前均无明显扩张，而缝合组较吻合前均明显扩张；激光组和激光＋胶组胆总管黏膜下炎症反应较缝合组轻，无明显肉芽肿形成，纤维排列较缝合组整齐。电镜观察证实，每组胆总管内置支架表面随时间的延长由光滑变得粗糙，其截面由致密逐渐变得疏松。结论：CO₂激光焊接辅以化学胶I期修复内置可降解支架胆总管切口安全、可行，其效果优于单纯缝合及CO₂激光焊接。

关键词: 激光, 焊接, 化学胶, 支架

Abstract: To explore the feasibility and safety of repairing common bile duct with laser-welding assited with glue after placing a degradable stent in it. Methods A total of 45 local healthy hybrid dogs were chosen and treated with choledochotomy.According to the primary repairing methods，the dogs were divided into three groups averagely and randomly：single suturing group(SSG),laser-welding group(LWG) and laser-welding assisted with chemical glue group(LWACGG).Before repairing，a degradable sent PLA was inserted into the common bile duct.The anastomotic time of common bile duct was recorded，measure the intention of the bursting pressure and the diameter of the anastomotic stoma were measured，the pathologic changes of the anastomotic stoma and appearance of stents were observed under electron microscope.Results Compared with the single suturing group，the anastomotic time in laser-welding group and laser-welding assisted with chemical glue group was more shorter (P<0.05); at the 1st，4 th and 12 th week after operation，there were not any significant differences of the intention of the bursting pressure between the single suturing group and laser-welding assisted with chemical glue group(P>0.05)，but it in laser-welding group was more lower than those in both groups mentioned above(P<0.05).At the 4 th，12 th week after operation， the diameters of the stoma didn’t dilate obviously in the laser-welding group and laser-welding assisted with chemical glue group compared with before anastomosis，but it dilated markedly in the single suturing group.Histological observation result showed less fibrosis and less inflammation reaction in the laser-welding and laser-welding assisted with chemical glue groups， but more serious inflammation could be seen in the single suturing group. The SEM photos showed the surface of the stents turned from initially smooth into rough and the cross-sections turned from compact into porous during degradation. Conclusion It is possible and safe of repairing common bile duct with laser welding assisted with chemical glue after placing a degradable stent in it.

Key words: lasers, welding, chemical glue, stents

中图分类号:

R657.4

刘铜军，姜伟，于惠秋，景遐斌，陈学思，李建国，李鹏飞. CO₂激光焊接辅以化学胶Ⅰ期修复犬内置可降解支架胆总管的可行性及全性[J]. J4, 2007, 33(3): 449-453.

LIU Tong-jun， JIANG Wei， YU Hui-qiu，JING Xia-bin，CHEN Xue-si，LI Jan-guo，LI Peng-fei. Feasibility and safety of repairing dog common bile duct with laser welding assisted with chemical glue following placing degradable stent in it[J]. J4, 2007, 33(3): 449-453.

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CO₂激光焊接辅以化学胶Ⅰ期修复犬内置可降解支架胆总管的可行性及全性

Feasibility and safety of repairing dog common bile duct with laser welding assisted with chemical glue following placing degradable stent in it

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