功能性肺叶切除动物模型的建立及相关指标监测
发布时间：2019-01-11 07:48
【摘要】：目的:使用碘化油、平阳霉素乳剂支气管肺泡灌注配合靶支气管栓塞建立功能性肺叶切除动物模型,评价功能性肺叶切除术的可行性、安全性。 方法:健康杂种犬18只,随机分成3组,每组6只,A组(实验组)行靶肺支气管肺泡灌注碘化油、平阳霉素乳剂后靶支气管聚甲基丙烯酸甲酯(Polymethylmethacrylate,PMMA)堵塞;B组行靶支气管PMMA栓塞,C组行单侧外科靶肺叶切除。分析各组术前、术后即时、术后1、2、3、4周的动脉血气变化,并用spss软件分析三组间有无统计学差异,4周后作胸部X线,处死动物行肺部组织病理学检查和靶肺组织细菌学培养。 结果:3组动物术后即时动脉PaO_2均低于术前(P0.01),术后动脉PaCO_2显著高于术前(P0.01),术后1周动脉血气恢复到术前正常水平,与术前无统计学差异(P0.05);术后B组PaCO_2较A组下降程度轻(P0.01),A、C组之间术后即时及术后1～4周血气变化无明显统计学差异P0.05。术后1～4周A、B、C3组间血气无明显统计学意义。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肺泡萎陷、肺间质纤维化,靶肺组织细菌学培养阴性。B组有3例肺不张形成,靶肺未见明显纤维化。C组有一只动物因伤口感染于术后4d死亡。 结论:通过靶肺支气管肺泡灌注碘化油、平阳霉素乳剂后靶支气管堵塞可使靶肺形成肺不张、纤维化,达到功能性肺叶切除术目的。该术式创伤小,安全、有效,有望部分替代外科性肺叶切除。
[Abstract]:Objective: to establish the animal model of functional lobectomy by using lipiodol, Pingyangmycin emulsion bronchoalveolar perfusion and target bronchus embolization, and to evaluate the feasibility and safety of functional lobectomy. Methods: eighteen healthy mongrel dogs were randomly divided into 3 groups (6 in each group). Group A (experimental group) was perfused with lipiodol oil in target lung and alveoli, and polymethyl methacrylate (Polymethylmethacrylate,PMMA) was blocked in target bronchus after pingyangmycin emulsion. Group B underwent PMMA embolization of the target bronchus and group C underwent unilateral surgical resection of the pulmonary lobes. The changes of arterial blood gas in each group were analyzed before and immediately after operation. The changes of arterial blood gas were analyzed by spss software. Chest X-ray was performed 4 weeks later. Lung histopathological examination and bacteriological culture of target lung tissue were performed. Results: the arterial PaO_2 of the three groups was significantly lower than that of preoperation (P0.01), the arterial PaCO_2 was significantly higher than that of preoperation (P0.01), and the arterial blood gas returned to the normal level 1 week after operation. There was no statistical difference between the two groups (P0.05). The decrease of PaCO_2 in group B was lighter than that in group A (P0.01). There was no significant difference in blood gas changes between group A and group C (P 0.05). There was no significant difference in blood gas between group A and B 3 at 1 and 4 weeks postoperatively. At the 4th week after operation, pulmonary atelectasis was found in the target lung of the experimental group. Histopathology showed the alveolar collapse, interstitial fibrosis and negative bacteriological culture of the target lung. In group B, there were 3 cases of atelectasis. No fibrosis was found in the target lung. In group C, one animal died of wound infection 4 days after operation. Conclusion: target bronchoalveolar infusion of lipiodol and blockage of target bronchus after pingyangmycin emulsion can cause atelectasis and fibrosis of target lung and achieve functional lobectomy. The surgical procedure is safe and effective, and it is expected to replace surgical lobectomy.
【学位授予单位】：武汉大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R-332
本文编号：2406865
[Abstract]:Objective: to establish the animal model of functional lobectomy by using lipiodol, Pingyangmycin emulsion bronchoalveolar perfusion and target bronchus embolization, and to evaluate the feasibility and safety of functional lobectomy. Methods: eighteen healthy mongrel dogs were randomly divided into 3 groups (6 in each group). Group A (experimental group) was perfused with lipiodol oil in target lung and alveoli, and polymethyl methacrylate (Polymethylmethacrylate,PMMA) was blocked in target bronchus after pingyangmycin emulsion. Group B underwent PMMA embolization of the target bronchus and group C underwent unilateral surgical resection of the pulmonary lobes. The changes of arterial blood gas in each group were analyzed before and immediately after operation. The changes of arterial blood gas were analyzed by spss software. Chest X-ray was performed 4 weeks later. Lung histopathological examination and bacteriological culture of target lung tissue were performed. Results: the arterial PaO_2 of the three groups was significantly lower than that of preoperation (P0.01), the arterial PaCO_2 was significantly higher than that of preoperation (P0.01), and the arterial blood gas returned to the normal level 1 week after operation. There was no statistical difference between the two groups (P0.05). The decrease of PaCO_2 in group B was lighter than that in group A (P0.01). There was no significant difference in blood gas changes between group A and group C (P 0.05). There was no significant difference in blood gas between group A and B 3 at 1 and 4 weeks postoperatively. At the 4th week after operation, pulmonary atelectasis was found in the target lung of the experimental group. Histopathology showed the alveolar collapse, interstitial fibrosis and negative bacteriological culture of the target lung. In group B, there were 3 cases of atelectasis. No fibrosis was found in the target lung. In group C, one animal died of wound infection 4 days after operation. Conclusion: target bronchoalveolar infusion of lipiodol and blockage of target bronchus after pingyangmycin emulsion can cause atelectasis and fibrosis of target lung and achieve functional lobectomy. The surgical procedure is safe and effective, and it is expected to replace surgical lobectomy.
【学位授予单位】：武汉大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R-332
【参考文献】
相关期刊论文 前6条
1 徐抴,王云杰,刘锟,高坤祥;兔肺减容手术前后肺内细胞增殖与凋亡的实验研究[J];第四军医大学学报;2002年12期
2 钟南山;肺减容术治疗肺气肿[J];中华外科杂志;1998年05期
3 赵凤瑞,郭永庆,刘德若;支气管堵塞法肺减容治疗肺气肿成功停用呼吸机1例[J];中华胸心血管外科杂志;2001年03期
4 姜格宁,丁嘉安,童稳圃,周晓,朱余明,杨健;肺减容术治疗重度肺气肿43例疗效分析[J];中华胸心血管外科杂志;2002年05期
5 侯生才,苗劲柏,陈航,胡滨,李彤,张振葵,王洋;肺减容术后早期肺功能及肺血流动力学的变化[J];中华胸心血管外科杂志;2003年01期
6 曲家骐,高昕,童向东,陈萍,陈宪英;肺减容术治疗慢性阻塞性肺气肿[J];中国胸心血管外科临床杂志;2002年01期
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