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背景:控制感染是保证喉移植成功的关键。在实践中应探索如何最低限度地减少感染,使重建血运后的供体喉在免疫抑制状态下先成活,之后再恢复喉的呼吸、吞咽、发音功能。目的:为减少感染,探讨采用分期移植方法进行同种异体喉移植的可行性。方法:根据体质量、喉体大小将10只雄性同种比格犬配对成5组供受体,采用异体喉移植方式,埋置在受体犬颈部皮下,每日应用免疫抑制剂抗机体免疫排斥,待喉体成活后再将供体喉与受体分别行咽部、气管对位吻合,建立Ⅱ期喉移植动物模型。结果与结论:Ⅰ期喉植入后,供喉生存良好,血运可。颈部纵切口的1号和颈部横切口的4,5号犬伤口生长良好,4,5号供喉未发生感染现象,最长可至4周后行Ⅱ期再植;U形切口的2,3号犬皮瓣坏死,供喉不同程度发生感染,2号喉坏死,3号经处理后喉存活。供喉在受体内生存最长可达4周。提示将喉移植分期进行,供喉摘除后预埋置法模式可以避免、减少移植后的喉体感染,受体犬耐受,供喉易成活,可以进行Ⅱ期的喉再造。移植后的主要组织学变化是黏膜上皮的改变,可以此作为观察免疫抑制反应的指标。需要处理的是埋置喉的腺体分泌问题,免疫抑制剂必须连续长期应用。
Background: Infection control is the key to successful laryngeal transplantation. In practice, we should explore how to minimize the infection, so that the donor throat after revascularization can survive in the state of immunosuppression and resume the respiration, swallowing and phonation of the larynx. Objective: To reduce the infection, explore the feasibility of using staging transplantation for allogeneic laryngeal transplantation. Methods: According to the body mass, the size of the throat of 10 male beagle dogs paired into five groups for the recipient, the use of allogeneic laryngeal transplantation, embedded in the recipient canine neck subcutaneous daily application of immunosuppressive agents against the body Immune rejection, to be alive after the throat and then the donor throat and the receptor were pharyngeal, tracheal alignment, the establishment of a model of laryngeal transplantation. RESULTS AND CONCLUSION: After laryngeal laryngeal implantation, the larynx had good survival and blood supply. No.4 and No.4 dogs in the longitudinal incision of the neck were well tolerated and no infection was found in the No.4 and No.5 laryngeal wounds. Dog flap necrosis No. 3, for varying degrees of laryngeal infection, No. 2 laryngeal necrosis, throat No. 3 after treatment survived. Laryngeal for survival in the recipient up to 4 weeks. It is suggested that laryngeal transplantation can be performed in stages, and the pre-laryngeal method can be avoided after laryngectomy. It can reduce the infection of the laryngeal tract after transplantation and the tolerance of the canine for the survival of the larynx. The major histological changes after transplantation are changes in mucosal epithelium as an indicator of the immunosuppressive response observed. Need to deal with the secretion of laryngeal gland secretion problems, immunosuppressive agents must be continuous long-term application.