Cardiomyoplastyにおける人工二重心膜による骨格筋癒着防止と硬化

人工双心包在心肌成形术中预防和硬化骨骼肌粘连

• 批准号: 08771016
• 负责人: 竹村 博文
• 金额: $ 0.7万
• 依托单位: Kanazawa University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-08771016/
• 关键词: Cardiomyoplasty; 骨格筋; 人工心腔; PTFE

【目的・方法】Cardiomyoplastyにおいて心臓に巻き付けた骨格筋が胸骨,心膜に強固に癒着し,骨格筋が自由に動けず,心機能補助に制限があることが報告されている.これまでの我々の研究においても慢性期に開胸してみると,骨格筋が胸骨に強固に癒着しており,非開胸時より癒着剥離の為心機能が著明に改善することが観察されていた.骨格筋の癒着を防止しなめらかな自由な骨格筋運動をさせるために人工心膜を考案し,その有効性を検討した.人工心膜の素材としては今回はPTFEを用い二重構造のsacを作成し心臓をくるめるように形成し,中空に水,オリーブ油を充填した.Cardiomyoplastyのモデル作製.成犬雑種10頭を用い,全身麻酔下に左広背筋を遠位付着部位で剥離遊離し,第3肋骨切除部位から有茎に広背筋を胸腔内に誘導し,心臓に巻き付けるように心外膜に固定した.その外側に作製した人工心膜を心臓ならびに骨格筋を包むように固定した.骨格筋に電気刺激用のペースメーカーリ-ドを縫着し,連続刺激ペースメーカーを接続した.手術終了後2週間後からペースメーカーで広背筋を刺激し,2カ月トレーニングし,非疲労性の筋へtransformationさせた.2カ月後人工心膜の効果を評価した.【結果】人工心膜の中空状態の作成に難渋し,中に充填した生理食塩水,オリーブ油は2ヶ月後には消失していた.また内外のPTFE膜は癒着しており,初期の目的のなめらかな人工心膜作成には至らなかった.心エコーを用いても骨格筋の外面は周囲と癒着しており,人工心膜を巻かないコントロール群と比較しても差はなかった.以上の結果から人工心膜の素材の選択,確実に中空を保てるsacの作成方法に問題があった.cardiomyoplastyは充分臨床応用可能で,今後は如何に効率よく骨格筋駆動の効果を引き出すかが課題で,今回の人工心膜もその一つの解決方法と思われる.

[objective] Cardiomyoplastyheart is responsible for the treatment of sternum, pericardial reinforcement, free movement of bone tendons, and the ability of the heart machine to help limit the cost of medical reports. In this study, the chest was opened in the chronic phase, the sternum was strengthened and the sternum was fastened to the chest, and the heart machine was able to improve the performance of the chest during the chronic period. Bone latticed tendons are used to prevent the movement of free bone tendons and artificial pericardium. This time, the artificial pericardium is made of double-made sac to form the artificial pericardium, which is filled with hollow water and oil. Cardiomyoplasty is used to fill the heart. A variety of 10-year-old dogs were used, the left dorsal tendons under general anesthesia were peeled off, the third rib was removed with stem and dorsal tendons in the thoracic cavity, and the epicardium was fixed. The artificial pericardium, the heart, the bone, the bone and the bone were fixed. The bone lattice electrical stimulation is connected with the bone lattice electrical stimulation, which is connected with the electrical stimulation. After 2 months of surgery, the artificial heart membrane of the artificial heart membrane showed severe pain after 2 months of surgery. [results] the hollow shape of the artificial heart membrane was made into a convulsion, the water was filled in the middle, and the oil disappeared after 2 months. [results] after 2 months of surgery, the artificial heart membrane of the artificial heart membrane became cold. [results] after 2 months of surgery, the artificial heart membrane was filled with water. In the initial stage, the artificial pericardium was made from the inner and outer PTFE membrane to the artificial heart. On the outside, the artificial pericardium is covered by the artificial pericardium, and the artificial pericardium is worse. The above results show that the material selection of artificial heart membrane is selected, and make sure that there is a problem in the construction of sac. Cardiomyoplasty is fully available, and how to improve the performance of bone lattice tendons in the future will lead to a problem. This time, the method of solving the problem of artificial heart membrane is very important.