本文選題：胰腸吻合器 + 甲基乙烯基硅橡膠��； 參考：《西安科技大學》2015年碩士論文

【摘要】：胰十二指腸切除術是胰腺、膽管與十二指腸區(qū)域各類腫瘤唯一根治的手段,但該切除術手術復雜且并發(fā)癥多,胰瘺就是其中最危險的并發(fā)癥之一,為了提高手術成功率、減少術后并發(fā)癥、降低患者的死亡率,對胰腸吻合術的研究便成了學者們的研究熱點,其中使用胰腸吻合器實施吻合術就是其中一個重要的方面。本論文研發(fā)設計了一種胰腸吻合器,以甲基乙烯基硅橡膠為基體材料,添加硫化劑過氧化二苯甲酰(BPO),加成硫化劑聚烴基氫硅氧烷,補強填料氣相法白炭黑,結構控制劑二苯基硅二醇,催化劑季銨堿,埋入鈦釘,一次硫化成型制備出胰腸吻合器。通過傅里葉變換紅外光譜(FTIR)對胰腸吻合器的化學結構進行表征,通過熱失重分析(TGA)和熱空氣老化試驗對其熱性能進行分析,通過力學性能實驗對其拉伸強度和斷裂伸長率進行測試,通過耐介質性測試觀察其接觸到水、酒精及雙氧水的性能變化,通過環(huán)氧乙烷滅菌測試測定其滅菌前后力學性能的變化。進行了家犬活體實驗,通過切斷空腸、破壞粘膜,胰腺套入空腸,吻合器包裹套端,固定吻合器,完成了活體手術。通過腹部X光片對胰腸吻合器的水平方向及垂直方向的鈦釘對位進行觀察,通過病理學分析胰腺與腸壁之間纖維組織增生情況,通過解剖學分析試驗犬腹部各器官的變化。結果表明:FTIR證實了聚烴基氫硅氧烷上的Si-H與硅橡膠中的-C=C之間硅氫加成反應的進行。二苯基硅二醇可有效消除氣相法白炭黑的結構化現(xiàn)象,使胰腸吻合器表面平整、均一。吻合器長16cm,寬1cm。厚0.2cm,且長度可根據(jù)病灶部位進行修剪。斷裂伸長率和拉伸強度達282.6%和2.17MPa,質量損失5%時所對應的溫度為429.9℃,經歷280℃×6h的熱空氣,其斷裂伸長率和拉伸強度僅下降了25.6%和2.3%。經過蒸餾水、75%酒精、3%雙氧水,NaOH(pH=9)和HCl(pH=0.8)浸泡的吻合器表觀無變化,質量損失僅為5.63%、1.52%、4.08%、5.20%和2.26%。經環(huán)氧乙烷滅菌后的吻合器,其力學性能和外觀無變化。醫(yī)學分析表明:吻合器鈦釘均勻垂直地刺入進胰腺組織內,無脫落、降解、移位;術后第10天胰腺與腸壁之間已有大量纖維組織增生,毛細血管形成,十二指腸和胰腺已能進行正常的血液循環(huán),且試驗犬腹部各器官無明顯腫脹,無胰瘺、膿腫、出血,腹腔內無明顯腹水形成。通過本論文的研究,我們發(fā)現(xiàn)硅橡膠因其生理無毒性可以用來制作吻合器,并能滿足各指標要求;與傳統(tǒng)的胰腸吻合術相比,使用吻合器的吻合口質量好,手術時間短,手術難度低�？烧f明使用胰腸吻合器改進胰十二指腸切除術是一個切實可行的辦法。本論文的研究既加強了材料學科與生物醫(yī)學學科之間的交流溝通,也為今后新材料的研發(fā)方向提供了一個新的參考。
[Abstract]:Pancreaticoduodenectomy is the only way to cure all kinds of tumors of pancreas, bile duct and duodenum, but it is complicated and has many complications. Pancreatic fistula is one of the most dangerous complications. To reduce postoperative complications and reduce the mortality of patients, the research on pancreaticojejunostomy has become a hot research topic, among which the use of pancreaticointestinal stapler is one of the important aspects of pancreaticojejunostomy. In this paper, a pancreaticojejunal stapler was developed and designed, in which methyl vinyl silicone rubber was used as the matrix material, the vulcanizing agent was added with dibenzoyl peroxide (BPO), the addition agent was polyalkylhydrosiloxane, and the filler was reinforced with silica by gas phase method. The pancreaticointestinal stapler was prepared by the structure control agent diphenylsilyl diol, catalyst quaternary ammonium base, embedded titanium nail, and first vulcanization. The chemical structure of pancreaticointestinal stapler was characterized by Fourier transform infrared spectroscopy (FTIR), and its thermal properties were analyzed by thermogravimetric analysis (TGA) and thermal air aging test. The tensile strength and elongation at break were tested by mechanical property test, and the changes of properties of water, alcohol and hydrogen peroxide were observed by medium resistance test. The mechanical properties before and after sterilization were measured by ethylene oxide sterilization test. By cutting the jejunum, destroying the mucous membrane, inserting the pancreas into the jejunum, wrapping the end of the stapler and fixing the stapler, the in vivo operation was carried out. The horizontal and vertical orientation of pancreaticointestinal stapling was observed by abdominal X-ray film. The proliferation of fibrous tissue between pancreas and intestinal wall was analyzed by pathology. The changes of abdominal organs in dogs were analyzed by anatomy. The results show that the Si-H reaction between Si-H on polyalkylhydrosiloxane and Con C in silicone rubber is confirmed by WFTIR. Diphenyl silyl can effectively eliminate the structured phenomenon of gas phase silica and make the surface of pancreaticointestinal stapler smooth and uniform. The stapler is 16 cm long and 1 cm wide. The thickness is 0.2 cm, and the length can be pruned according to the location of the lesion. The elongation at break and tensile strength reached 282.6% and 2.17 MPA, and the corresponding temperature was 429.9 鈩，

本文編號：1996993