摘要
目的观察紫杉醇生物可降解支架对猪胆管损伤后胆管狭窄的防治作用。方法紫杉醇涂层支架采用紫杉醇浸泡法制作。高压液相法（HPLC）测定该支架体外紫杉醇释放率。选取30头猪用于动物实验。将紫杉醇支架及裸支架分别置入猪胆管中，每组15头。分别于术后1、3及6个月取材，观察并测定2组动物的吻合口直径，行胆道造影并观察2组动物吻合口瘢痕的组织学变化。结果我们研发了一种全新的紫杉醇完全可降解胆道支架。HPLC法测得支架30d释放紫杉醇含量为281Ng，占支架总紫杉醇含量30．4％。所有手术均顺利完成，术后恢复顺利，无死亡及明显胆瘘发生。紫杉醇支架组术后1、3、6个月吻合口直径均大于裸支架组，其中术后3个月与6个月比较差异有统计学意义。术后胆道造影示紫杉醇支架组无明显胆管扩张现象，HE染色结果显示，术后各时段纤维增生情况紫杉醇支架组均比裸支架组减轻。结论紫杉醇涂层可降解支架可抑制猪损伤后胆管狭窄，而且不影响胆管正常愈合过程。
Objective To evaluate the effect of a biodegradable paclitaxel-eluting biliary stent on bile duct scar formation and biliary stricture by observing the healing process after stent placement in a porcine billiary model. Methods A novel biodegradable paclitaxel-eluting biliary polylactide stent was manufactured by immersion method. The efficacy of drug release for paelitaxel-eluting biliary stent was investigated by HPLC. Paclitaxel-eluting stent were surgically inserted in the bile duct of fifteen swines in experimental group while stent without paclitaxel were placed in other fifteen swines in control group. Animals were sacrificed after 1,3,6 months. The anastomic healing of the common bile duct was observed. The size of anastomosis was measured and compared between the two groups. Result A novel biodegradable paclitaxel-eluting biliary stent was manufactured. The total amount of paclitaxel released was about 281 I^g （30. 4% ） over a month as determined with HPLC methods. There was no death, no leakage. The diameter of anastomosis in the experimental group was significantly larger than that in control group. Cholangiography did not show obvious bile duct dilatation in experimental group. Histologic examination showed less hyperplasia of the bile duct wall in the experimental group than that in control group. Conclusion Release of paclitaxel via a biodegradable stent relieves billiary stricture in porcine model and have no obvious negative influence on wound healing of the common bile duct.
出处
《中华普通外科杂志》
CSCD
北大核心
2013年第11期842-845,共4页
Chinese Journal of General Surgery
关键词
创伤和损伤
胆管
紫杉醇
Wounds and injuries
Bile ducts
Paclitaxel
