单纯肺组织瓣修补气管缺损的临床应用

doi:10.3877/cma.j.issn.2095-8773.2016.03.07

中华胸部外科电子杂志 ›› 2016, Vol. 03 ›› Issue (03) : 160 -163. doi: 10.3877/cma.j.issn.2095-8773.2016.03.07

所属专题：文献；

论著

单纯肺组织瓣修补气管缺损的临床应用

陈宽冰¹, 宣莹¹, 王一北¹, 石文君¹^,^†(

)

^1. 110004　沈阳，中国医科大学附属盛京医院胸外科

收稿日期:2016-05-20 出版日期:2016-08-28
通信作者: 石文君

Clinical application of replacement of tracheal defects with single autologous lung tissue flap

Kuanbing Chen¹, Ying Xuan¹, Yibei Wang¹, Wenjun Shi¹^,^†()

^1. Shengjing Hospital of China Medical Univercity, Shenyang 110004, China

Received:2016-05-20 Published:2016-08-28
Corresponding author: Wenjun Shi
About author:
Corresponding author:Shi wenjun,shiwj@sj-hospital.org

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目的

探讨单纯应用自体肺组织瓣修补气管缺损的临床应用效果。

方法

对确诊的6例气管肿瘤患者，其中4例为主气管肿瘤，2例为左主支气管肿瘤，均采用自体肺组织瓣修补气管缺损方法行胸段气管重建术。

结果

6例患者呼吸困难均明显缓解，气管缺损处肺组织瓣重建愈合良好，重建气管无明显狭窄及肉芽组织形成。术后随访显示所有患者疗效稳定，其中5例随访至今均健在，最长存活时间达10年；1例患者术后1年失访。

结论

自体肺组织瓣修补气管缺损是一种可行的气管重建新方法。

关键词: 肺组织瓣, 气管缺损, 气管重建

Objective

To investigate the feasibility of replacement of tracheal defects with single autologous lung tissue flap.

Methods

Replacement of tracheal defects with autologous lung tissue flap and tracheal reconstruction were performed in 6 cases with tracheal tumors. Among these 6 cases, 4 were diagnosed as main tracheal tumors, and the other 2 left principal bronchus tumors.

Results

Dyspnea was significantly relieved in all patients after operation. The reconstructed lung tissue flap healed well. No stenosis and granulation tissue was observed in the prosthetic lumen. The outcomes of patients were favorable during follow-up. One case was lost in follow-up 1 year later, and the other 5 were followed up until now and were still alive, with the longest survival of 10 years.

Conclusions

Replacement of tracheal defects with single autologous lung tissue flap is a new feasible tracheal reconstruction method.

Key words: Lung tissue flap, Tracheal defects, Tracheal reconstruction

表1 6例气管肿瘤患者的一般资料

病例	年龄(岁)/性别	病因	临床症状	病程	基础疾病	病变位置	病变范围
1	51/M	无	呼吸困难	6个月	无	下段主气管	3.0 cm
2	64/M	无	胸闷气短	41个月	无	左主支气管	2.5 cm
3	71/F	无	呼吸困难	9个月	糖尿病	左主支气管	3.0 cm
4	47/F	无	气短	7个月	无	下段主气管	3.0 cm
5	55/M	无	呼吸困难	11个月	无	下段主气管	4.0 cm
6	38/M	无	气短	13个月	无	下段主气管	3.0 cm

表1 6例气管肿瘤患者的一般资料

病例	年龄(岁)/性别	病因	临床症状	病程	基础疾病	病变位置	病变范围
1	51/M	无	呼吸困难	6个月	无	下段主气管	3.0 cm
2	64/M	无	胸闷气短	41个月	无	左主支气管	2.5 cm
3	71/F	无	呼吸困难	9个月	糖尿病	左主支气管	3.0 cm
4	47/F	无	气短	7个月	无	下段主气管	3.0 cm
5	55/M	无	呼吸困难	11个月	无	下段主气管	4.0 cm
6	38/M	无	气短	13个月	无	下段主气管	3.0 cm

图1 主支气管肿瘤患者术前检查结果。A：CT检查；B:纤维支气管镜检查

图2 左主支气管肿瘤患者手术中。A：术中切除气管肿瘤；B：术中肺组织瓣修补气管缺损

图3 主支气管肿瘤患者术后复查结果。A：CT扫描；B：CT加三维重建

[1]	AlonsoWA,BridgerGP,BordleyJE. Tracheal transplantation in dogs[J] . Laryngoscope, 1972, 82 (2) : 204-209.
[2]	WrightCD,GrilloHC,WainJC, et al. Anastomotic complications after tracheal resection：prognostic factors and management[J]. J Thorac Cardiovasc Surg, 2004, 128(5): 731-739.
[3]	HindererS,Schenke-LaylandK. Tracheal tissue engineering：building on a strong foundation[J]. Expert Rev Med Devices, 2013, 10(1)：33-35.
[4]	赵俊刚，石文君，张苏宁，等. 肺组织瓣修补胸内食管不规则缺损的新术式研究[J]. 中国医科大学学报，2005，34(2)：127-131.
[5]	GrilloHC. Tracheal replacement [J] . Ann Thorac Surg, 1990, 49 (6) ：864-865.
[6]	MartinodE,SeguinA,RaduDM, et al. Airway transplantation: a challenge for regenerative medicine [J] . Eur J Med Res, 2013, 18 (1) : 25.
[7]	孙延奇，马建群，徐海. 组织工程化气管研究：软骨及血供障碍的突破[J]. 中国组织工程研究，2014, 18 (24) : 3894-3899.
[8]	MacchiariniP,JungebluthP,GoT, et al. Clinical transplantation of a tissue-engineered airway [J] . Lancet, 2008, 372 (9655) : 2023-2030.
[9]	GonfiottiA,JausMO,BaraleD, et al. The first tissue-engineered airway transplantation: 5-year follow-up results [J]. Lancet, 2014, 383(9913) : 238-244.
[10]	ElliottMJ,De CoppiP,SpeggiorinS, et al. Stem-cell-based, tissue engineered tracheal replacement in a child: a 2-year follow-up study [J] . Lancet, 2012, 380 (9846) : 994-1000.

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Clinical application of replacement of tracheal defects with single autologous lung tissue flap

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Clinical application of replacement of tracheal defects with single autologous lung tissue flap