103钯支架预防犬胆管损伤后狭窄的实验研究
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何贵金

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Experimental study on the use of 103Pd radioactive stent in the prevention of post-traumatic bile duct stricture in dogs
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    摘要:

    目的:探讨103Pd(103钯)支架及胆管内放射对胆管损伤后狭窄的预防作用。方法:健康犬12只,随机分为2组:(1)实验组(n=6),即103Pd支架组,实验术中经胆总管末端开口,将Forgort气囊导管插入胆总管内,进行球囊扩张术,然后用11F医用推送器将103Pd支架送至目标的胆管段。(2)对照组(n=6),实验方法同实验(1)组,但采用普通支架植入。术后30d,用γ计数器进行胆管及周围组织放射性测定、免疫组织化学测定、组织病理学和胆管造影检查。计算机图像分析胆管组织形态学的变化。结果:普通支架组术后30d胆管损伤处,胆管黏膜断裂,内膜增生及管腔狭窄。103Pd支架组:胆管内放射治疗后30d与普通支架组比明显减少胆管内膜增生厚度(P<0.01)。胆管狭窄面积百分比,普通支架组为(60±21.6)%,103Pd支架组为(31.6±9.5)%(P<0.01),103Pd支架组胆管腔面积比普通支架组明显增加(P<0.01)。结论:在球囊扩张致胆管损伤术后即刻应用103Pd支架胆管腔内放射植入及行内照射治疗,可有效地预防犬的胆管损伤术后30d胆管内膜增生和胆管狭窄。

    Abstract:

    Abstract:Objective:To investigate the preventive effects of 103Pd radioactive stent on stenosis after bile duct injury in dogs.Methods:Twelve healthy dogs (15~20kg) were randomly divided into 103Pd radioactive stent group (n=6) and control group (n=6). Immediately after balloon dilatation injury to the bile duct, the 103Pd radioactive stent(experiment group) or the ordinary stent(control group) was positioned into the target segment. The dogs were killed one month later. The injured bile duct segments were dissected free from the dogs, and were examined radionucleonically, immunohistochemically and pathologically. Muscular proliferation area and lumen area were determined by computer-assisted picture analysis system. Results:In the control group, 30 days after ductal injury, the mucosa of the bile duct was fractured, the mucosa was proliferated and the lumen stenosed.Compared with the control group, 103Pd radioactive stent significantly reduced muscular proliferation area (P<0.01), decreased percentage of stenosis area [(60±21.6)% vs (31.6±9.5)%], and increased bile duct lumen area (P<0.01). Conclusions:103Pd radioactive stent is feasible and effective in reducing muscular proliferation and preventing stenosis 30 days after balloon dilatation injury to the bile duct in dogs.

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何贵金,张宏,许书河,戴显伟,姜卫国,高红.103钯支架预防犬胆管损伤后狭窄的实验研究[J].中国普通外科杂志,2005,14(1):8-.
DOI:10.7659/j. issn.1005-6947.2005.01.008

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  • 在线发布日期: 2005-01-25