摘要
目的:为了开展磁铁压迫吻合术治疗不宜手术的肠梗阻,开发系列磁铁并进行了深入研究。方法:雌、雄性杂种犬9只;钐钴(Samarium-Cobalt)磁铁2块,直径15～20mm,厚3～5mm,2300～3200G。肌内注射麻醉。切开回肠末端,将一磁铁块置入其近侧回肠内(子磁铁);将另一磁铁块置入结肠内(母磁铁)。结扎子母磁铁之间的回肠,致完全梗阻。摄腹平片,观察2块磁铁之间的距离、在腹部的位置、自肛门排出的时间、排出后实验犬进食情况;活体观察内瘘的完整性、蠕动情况;组织学观察压迫吻合内瘘标本。结果:腹平片示两磁铁块之间的缝隙从1.5mm缩小至0.5mm。2300～2770G组磁铁排出时间为术后6～14d。解剖学观察:磁铁压迫吻合内瘘完整;组织学观察:内瘘呈坏死层、肉芽层及瘢痕层特异性结构,慢性损伤后修复性改变。长期存活犬能正常饮食。3200G组磁铁排出时间为术后3～4d,实验犬因肠穿孔而死亡。结论:磁铁压迫吻合术治疗犬肠梗阻,2300～2770G的磁铁为安全治疗范围。有望在中国应用于临床。
Objective： To make magnetic compression anastomosis between the small intestines as a novel treatment, using the advances in interventional radiology. Methods： One magnet was put into the ileum of an adult dog, another magnet was put into the colon of the dog, the ileum between the two magnets was ligatured causing a complete obstruction of the small intestine. Two magnets were immediately attracted towards each other transmurally, so that the walls of intestine were compressed together. Results： Two magnets compressed the stricture transmuralty, causing gradual ischemic necrosis of the stricture. The ischemic necrosis created an anastomosis between the two magnets. The magnets of 2 300-2 770 gauss were discharged from the anal 6-14 days after the procedure. There was a complete fistula between the ileum and the colon. The magnets of 3 200 gauss were discharged 3-4 days post the procedure, and two dogs were died of perforation on colon caused by the magnets of 3 200 gauss. Conclusion Magnetic compression anastomosi.s（MCA） is a novel interventional method that creates an anastomosis between the small intestine and the colon. The magnets from 2 300-2 770 gauss are safe. MCA could be applied in patients.
出处
《中国现代普通外科进展》
CAS
2009年第8期649-652,共4页
Chinese Journal of Current Advances in General Surgery
基金
首都医学发展基金自主创新项目(2005-3107)
关键词
磁铁压迫吻合术
肠梗阻
肠瘘
狗
Magnetic compression anastomosis（MCA）
Bowelobstruction
Intestinalfistula
Dogs
