纤维支气管镜肺减容术所需绵羊肺气肿模型的建立

发布时间：2018-05-02 13:02

  本文选题：纤维支气管镜肺减容术 + 绵羊　； 参考：《天津医科大学》2007年硕士论文

【摘要】： 目的：研究应用木瓜蛋白酶局部气管内滴注法建立纤维支气管镜肺减容术所需绵羊不均一肺气肿模型的安全性及其特点，并初步研究肺气肿电镜下病理学改变。 方法：健康成年绵羊20只，麻醉后气管内插管，局部肺段滴注木瓜蛋白酶75U／kg，同时麻醉机给予正压通气15分钟，潮气量12ml／kg，呼吸频率15次／min，氧流量6L／min，连续4周制成不均一肺气肿模型。模型制作完2周后观察血气分析、肺功能及影像学改变。将其中6只动物处死(静脉注射戊巴比妥钠100mg／kg)，取出完整肺组织，将其充气并放置在2.5L生理盐水中，保持肺组织处于20cmH_2O的压力中。将滴注木瓜蛋白酶的靶段肺组织及未滴注的肺组织分别取材，经光学显微镜观察其病理学改变，透射电镜下观察各细胞的亚细胞结构改变肺组织病理学改变。 结果：20只绵羊中的17只成功复制出肺气肿模型，成功率85％，其余1只由于肺大泡破裂死亡(5％)，1只死于双肺感染并发脓胸(5％)，另外1只由于术前禁食时间短，导致呕吐窒息死亡(5％)。17只成功复制出肺气肿模型的绵羊中，14只整个模型建立过程中未出现不良反应，3只出现间断咳嗽。实验前后氧分压、血氧饱和度改变有统计学意义，功能残气增加量改变有统计学意义。CT示气肿肺段肺纹理减少，肺野透过度增加。病理观察光镜示肺泡壁变薄、胀大，肺泡融合；电镜示Ⅱ型肺泡上皮细胞内见多量空泡，表面活性物质减少，，肺泡腔内见有分泌物。肺组织间见有凋亡小体。 结论：本实验的特点为(1)不均一的肺气肿模型与人类所患肺气肿类型更为接近；(2)气管内滴注方法建立模型稳定，方法简便，注药剂量准确，制作时间短，不易出现感染及不良反应；(3)经气管内滴注木瓜蛋白酶免受血液中弹性蛋白酶抑制因子的灭活。总之，木瓜蛋白酶局部气管内滴注能成功而安全的复制绵羊不均—肺气肿模型，该模型能满足BLVR动物实验的要求，CT及病理均证实符合不均—肺气肿改变。
[Abstract]:Objective: to study the safety and characteristics of sheep heterogeneous emphysema model with papain intratracheal instillation, and to study the pathological changes of emphysema under electron microscope. Methods: 20 healthy adult sheep were intubated with tracheal intubation after anesthesia, 75 U / kg papain was infused into the local lung segment, and positive pressure ventilation was given to the anesthetic machine for 15 minutes. The inhomogeneous emphysema model was made with tidal volume of 12 ml / kg, respiratory rate of 15 times / min and oxygen flow rate of 6 L / min for 4 weeks. Blood gas analysis, pulmonary function and imaging changes were observed 2 weeks after the model was made. Six of the animals were killed (intravenous injection of pentobarbital sodium 100 mg / kg 路kg ~ (-1), the intact lung tissue was taken out, then inflated and placed in 2.5 L saline to keep the lung tissue under the pressure of 20cmH_2O. The target lung tissue and the non-drip lung tissue of papain were collected, the pathological changes were observed by optical microscope, and the pathological changes of lung tissue were observed by transmission electron microscope (TEM). Results the emphysema model was successfully made in 17 of the 20 sheep, and the success rate was 850.The other one died of alveolar rupture, one died of double lung infection and the other one died of bilateral lung infection, and the other one died of short fasting time before operation. 14 of 17 sheep with emphysema were induced to die of vomiting asphyxia. No adverse reactions were found during the establishment of the model and 3 of them had intermittent cough. Before and after the experiment, the changes of oxygen partial pressure and oxygen saturation were statistically significant, and the increase of functional residual gas was statistically significant. Ct showed that the lung texture of emphysema decreased and the permeability of lung field increased. The pathological observation showed that the alveolar wall became thinner, enlarged and fused with alveoli under light microscope, and the vacuole was found in the alveolar epithelial cells of type 鈪

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