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新型人工肛门括约肌系统及初步动物实验研究

New artificial anal sphincter system and preliminary animal experiment

作者: 翁晓靖  颜国正  克磊  张根福  王永兵  刘华  刘志强 
单位:上海交通大学医学精密工程及智能系统研究所(上海200240)
关键词: 肛门失禁;人工肛门括约肌;无线;经皮能量传输系统;动物实验 
分类号:
出版年·卷·期(页码):2013·32·6(587-593)
摘要:

目的 研究可用于治疗肛门失禁的植入式人工肛门括约肌系统(artificial anal sphincter system,

AASS)。方法 系统由体内执行、体外控制和经皮能量传输3个模块构成,体内外通过无线模式通信。当体内

直肠壁上压力超出阈值后,向体外发送排便报警信号,患者通过体外控制模块控制体内执行模块打开或关闭

直肠,采用经皮能量传输模块为体内电池充电。通过1例猪的动物实验,评估在活体环境下系统各模块的可

靠性和稳定性。15d后将动物解剖,观察组织变化并进行体内的腹泻实验和血供实验。结果 植入体内后,体

外控制模块可实时控制体内执行模块的各项操作,通过经皮能量传输充电3h,在体内可持续工作24h。拟腹

泻状态下,对肠壁施加7.16kPa的压力(正常肛肠静息压为6.26~9.47kPa),能有效抑制肠道内容物渗漏。结

论 AASS可以模拟正常人体肛门括约肌功能,为严重肛门失禁的患者提供了一种新的治疗方法。

Objective To develop a new implantable artificial anal sphincter system (AASS) for

the treatment of fecal incontinence.Methods The system was composed of internal execution

prosthesis,external control module and wireless transcutaneous energy transmission system

(TETS).Wireless communication was used for the data transmission between the internal and

external.Once the rectal pressure exceeded the threshold,an alarm signal was sent to the

external to remind the patient for defecation.Patients controlled the internal execution

prosthesis to open or close the rectum through the external control module and the internal

execution module was charged through TETS.The system was implanted into a pig to evaluate the

stability of each part.After 15 days the pig was dissected to observe the changes and the

diarrhea and rectum blood experiments were conducted in vivo.Results External control module

achieved the real-time control of internal execution prosthesis.The internal execution module

could sustainably work 24 h after charging 3 h through TETS.Diarrhea experiment showed that

when the pressure of 7.16kPa was applied on the intestinal wall (normal anorectal resting

pressure:6.26-9.47kPa),the prosthesis could effectively suppress the leakage of intestinal

contents.Conclusions AASS could simulate the function of normal sphincter,as a new solution

for patients with severe fecal incontinence.

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