장막, 흉막 및 횡경막에 이식한 자가 기관의 생존 비교

Other Titles
Comparison of survival of tracheal autograft transplanted to pleura, omentum and diaphragm
Authors
박훈
Issue Date
2004-12
Awarded Date
2005
Abstract
기관 또는 기관지의 이식이나 기관문합술후 그리고 폐절제술후 기관지의 봉합면에 빠른 재혈관화를통해 감염이나 허혈성 괴사를 막기위해 장막, 심외막, 심외지방, 횡경막, 장막, 늑간 근육등을 이용하여 보강해 주는경우가 많다. 이 연구는 실험동물에서 자가기관을 흉막, 장막 및 횡경막에 이식했을 때 생존에 미치는 영향을 알아 보고자한다. 실험동물로는 무게는 250 ― 350g정도의 Sprague-Dawley rats가 사용되었다. 장막, 횡경막, 흉막 세군으로 나누어서 각 군별로 5마리씩 실험하였다. 복막내 마취후 기관 삽관을 시행하였고 기관을 노출시켜 세마디의 기관이식편을 잘라 내었다. 잘라낸 기관을 장막, 횡경막, 흉막에 각각 이식하였고 2주후 쥐를 희생시켜 얻은 조직으로 병리조직학적 검사를 하였다. 병리조직학적으로 절단기관편의 생존능력을 비교하기위하여 각각의 상피조직, 점막하조직, 연골조직의 괴사정도를 점수화하여(0-3점) 그 결과의 평균값을 표시하였다. 병리 조직학적 검사상 장막군이 가장 좋은 보존 상태를 보였다. 괴사 점수는 흉막이식군에서 상피층서 2.17±0.983, 점막하층 1.67±0.516, 연골층 2.17±0.753으로 나타났고 장막이식군의 경우 각각 1.00±0.00, 1.60±0.548, 1.8±0.447, 횡경막이식군은 1.40±0.894, 2.40±0.547, 2.2±0.447으로 관찰되었다. 전체 괴사 점수는 흉막이식군에서 6.00±1.789, 장막이식군에서 4.40±0.894, 횡경막이식군에서 6.00±1.414 보였다. 세 그룹간의 비교시 통계적 유의성은 없었으나 장막에 이식한 기관에서 가장 낮은 괴사점수가 나와 장막이 횡경막이나 흉막보다 기간 봉합면을 보호하고 신혈관 생성에 더 좋은 역할을 하는 경향을 보였다. Pleura, diaphragm, pericardial fat pad, intercostal muscles and omentum can be used to protect and revascularize the bronchial suture line of tracheal transplanation, lung transplantation and pulmonary resection. The purpose of the present study is to compare the influence of the pleura, diaphragm and omentum in survival of isolated tracheal segments in the experimental animals. Sprague-Dawley rats weighing 250 ― 350g were used. The animals were divided in three groups; the pleura, omentum and diaphragm. Following intraperitoneal anesthesia, endotracheal intubation was performed. Then the trachea was exposed. A three-ring section of cervical trachea was excised. And resected trachea was implanted at each sites. After 2 weeks, rats were sacrificed. Histopathological examination of the tracheal segments was performed. For comparison of each groups, histopathological viability of resected tracheal segment was scored by three tissue layers; epithelium, The results were presented as average score. In histopatholgical examination, submucosa and cartilage using tracheal segment necrosis scoring system. the pleural group showed well preserved tissue. there was minimal necrosis and inflammation compared with other groups. At the pleural group, tracheal necrosis scores were 2.17±0.983 at epithelium, 1.67±0.516 at submucosa and 2.17±0.753 at cartilage. At the omental group, scores were 1.00±0.00, 1.60±0.548 and 1.80±0.447. At diaphragmatic group, scores were 1.40±0.894, 2.40±0.547 and 2.20±0.447. Total necrosis score were 6.00±1.789 at the pleural group, 4.40±0.894 at the omental group and 6.00±1.414 at diaphragmatic group. There were no significant difference viability in terms of total necrosis score for the viability of resected tracheal segment. But the best result was achieved in the omental group.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/11971
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3. Thesis (학위논문) > 1. School of Medicine (의과대학) > 석사
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