【摘要】 目的通过动物实验研究介入性肺叶切除的可行性。方法健康犬12只,随机分成3组,每组4只,A组行靶肺支气管肺泡灌注碘化油、肺泡上皮细胞毁损混合剂及靶支气管聚甲基丙烯酸甲酯(PMMA)堵塞;B组行靶支气管PMMA栓塞,C组行肺叶切除。分析各组术前、术后即时、术后1~4周的动脉血气,4周后作胸部X线、组织病理学检查及靶肺组织细菌学培养。结果3组动物术后即时动脉血氧分压(PaO2)低于术前(P<0.01),动脉血CO2分压(PaCO2)显著高于术前(P<0.01);术后1周动脉血气恢复正常,与术前无显著差异(P>0.05);术后第4周肺部摄片及大体标本见实验组靶肺肺不张形成,组织病理学显示靶肺呈纤维化改变,靶肺组织细菌学培养阴性。B组有2例肺不张形成,靶肺未见明显纤维化。结论通过靶肺支气管肺泡灌注及靶支气管堵塞可使靶肺形成肺不张、纤维化,达到介入性肺叶切除术目的。更多还原

【Abstract】 Objective To study the feasibility of interventional pulmonary lobectomy by animal experiment. Methods Twelve healthy dogs were divided into three groups randomly,with 4 in each. Group A: the target bronchus and alveoli were filled with emulsion of lapiodal and alveolar cells damage liquors and then the target bronchus was occluded with Polymethylmethacrylate(PMMA). Group B: The target bronchus was only occluded with PMMA. Group C: Pulmonary lobe was resected surgically. Arterial blood gases were measured at the time of pre-procedure and post-procedure and then 1st, 2nd, 3rd and 4th week after the procedure respectively. Chest radiography histology and bacterial culture of tissue of target lung lobe were made after 4 weeks. Results There was a significant difference in arterial blood-gas among 3 groups pre-procedure in comparion with those of post-proceduce immediately (P<0.01), and no difference (P>0.05) in comparing with 1st, 2nd, 3rd and 4th week after the procedure. Atelectasis was shown radiologically with histological formation of fibrosis of target lung lobe but no bacteria grew in target tissue 4th week after the procedure. There were two cases of lung atelectasis but no pulmonary fibrosis occluded in group B. Conclusions Interventional pulmonary lobectomy might be obtained after the target bronchus and pulmonasy alveoli were filled with emulsion of dipiodal and alveolar cells damage liquors and then the target bronchus was occluded with PMMA.更多还原