阻塞性肺不张动物模型建立及MSCT与病理学对比研究
发布时间：2018-09-14 14:12
【摘要】：第一部分螺旋CT对日本大耳白兔气道的测量研究 目的:探讨日本大耳白兔气管和主支气管各种解剖径线的长度、角度及相关性,为进行气道疾病内支架介入治疗的动物实验研究奠定基础。 方法:多层螺旋CT扫描30例成年健康日本大耳白兔的颈胸部,测量气管各段前后径、左右径,使用MSCT技术将气管拉直,测算声门水平到隆突的气管长度,左右主支气管和中间支气管内径与长度,以及左、右主支气管长轴与矢状面的夹角。 结果:气管各段直径、左右肺尖叶支气管开口内径无差异,右主支气管内径大于左侧,而右主支气管长轴与矢状面夹角、长度则小于左侧,并有相关性。 结论:多层螺旋CT测定的日本大耳白兔气管、左和右主支气管径线值,获得左、右主支气管内径值、长度、嵴下角之间的回归方程,有助于为兔实验提供相关气管和支气管的解剖参数。 第二部分阻塞性肺不张动物模型的建立 目的:探讨日本大耳白兔气道内支架置入技术的方法,评价气管支气管一体化覆膜内支架封堵法建立阻塞性肺不张的动物模型的可行性,旨在建立一种新的比较接近生理状态的阻塞性肺不张动物模型。 方法:健康成年日本大耳白兔42只,雌雄不限,体重1.64～3.75kg,平均为2.50kg。随机分成7组,即2d、4d、1w、2w、1m、2m、3m组,每组6只。在DSA引导下使用浅麻醉方法,在42只兔气道内置入气管支气管一体化覆膜内支架。术前和在规定时间内分别测量体温、体重、白细胞计数、MSCT等,判断是否形成阻塞性肺不张。 结果:置入42个兔气道内支架,其中成功35例、支架位置不佳3例、术中死亡4例,置入成功率为83%,术后死亡3例,未形成肺不张2例,肺不张成功率74%。 结论:DSA引导下使用浅麻醉方法,置入气管支气管一体化覆膜内支架的方法制作阻塞性肺不张动物模型,方法简单,操作容易,内支架置入成功率和肺不张形成率均较高。 第三部分阻塞性肺不张动物模型的MSCT和病理学对比研究 目的:目前气管内支架置入术已成为治疗阻塞性肺不张一个行之有效的且微创的方法,但是确定治疗阻塞性肺不张的最佳时机还没有统一,该实验探讨肺不张动物模型的MSCT和组织学的相关性,有助于诊断和治疗阻塞性肺不张。 方法:选取48只成年健康日本大耳白兔,随机分成8组,每组6只,包括对照组1组,实验组7组。实验组中每只兔子放置气管支气管支架制作肺不张模型,在规定的时间内测量MSCT值并处死,取不张肺组织并切片,光镜下观察不同组不张肺的病理变化,分析两者相关性。 结果:不张肺的CT密度随着时间的延长而增加,MSCT影像征像和病理变化的相关性如下:前期4d内肺泡塌陷,肺泡间质毛细血管扩张有充血,肺不张的密度低,7d～1m期间由于肺组织出现炎性渗出,肺泡内有大量的炎性细胞,此期是阻塞性肺炎发生时期,密度值一般在30-40Hu之间,1月后肺组织炎症逐渐减轻,炎症细胞主要集中在细支气管周围,壁内炎细胞浸润。2月后细支气管粘膜层和平滑肌逐有破坏,3月肺组织内出现大量细支气管扩张,周围平滑肌缺少,内部充满大量的炎症细胞,肺泡上皮增生变厚。此期的MSCT密度在40Hu之上。增强显示不张肺强化不是十分均匀,7d和14d强化比较明显。 结论:阻塞性肺不张最佳治疗时机是支气管未破坏和形成支扩之前,CT值应是40Hu以下。阻塞性肺不张晚期最终进展为细支气管和支气管扩张。
[Abstract]:Part one measurement of airway in Japanese white rabbits by spiral CT
Objective: To investigate the length, angle and correlation of various anatomical diameters of trachea and main bronchus in Japanese big-eared rabbits, and to lay a foundation for the animal experimental study of stent interventional therapy for airway diseases.
Methods: 30 healthy adult Japanese rabbits were scanned by multi-slice spiral CT. The anterior and posterior diameters, left and right diameters of trachea were measured. The trachea was straightened by MSCT. The length of trachea from glottis level to carina, the inner diameter and length of left and right main bronchi and middle bronchi, and the angle between the long axis of left and right main bronchi and sagittal plane were measured.
Results: There was no difference in the diameter of each segment of the trachea and the inner diameter of the left and right pulmonary apical lobes. The inner diameter of the right main bronchus was larger than that of the left, while the length of the long axis of the right main bronchus was less than that of the left.
Conclusion: The regression equations between the diameters, lengths and angles of the left and right main bronchus can be obtained by measuring the diameters of the trachea, left and right main bronchus with multi-slice spiral CT, which is helpful to provide anatomical parameters of the trachea and bronchus in rabbits.
The second part is the establishment of animal models of obstructive atelectasis.
Objective: To explore the method of stent placement in the airway of Japanese big-eared rabbits and to evaluate the feasibility of establishing an animal model of obstructive atelectasis with tracheobronchial integrative covered stent occlusion.
Methods: Forty-two healthy adult Japanese white rabbits, male and female, weighing 1.64-3.75 kg, with an average of 2.50 kg, were randomly divided into 7 groups, namely, 2 days, 4 days, 1 w, 2 w, 1 m, 2 m, 3 m groups, with 6 rabbits in each group. Weight, white blood cell count, MSCT, etc., to determine whether the formation of obstructive atelectasis.
Results: 42 rabbit airway stents were implanted, of which 35 were successful, 3 were in poor stent position, 4 died during operation, the success rate was 83%, 3 died after operation, 2 did not form atelectasis, and the success rate of atelectasis was 74%.
Conclusion: The animal model of obstructive atelectasis was established by DSA-guided shallow anesthesia with tracheobronchial integrated covered stent implantation. The method is simple and easy to operate. The success rate of stent implantation and atelectasis formation rate are high.
The third part is a comparative study of MSCT and pathology in obstructive atelectasis animal models.
Objective: At present, endotracheal stenting has become an effective and minimally invasive method for the treatment of obstructive atelectasis, but the best time to determine the treatment of obstructive atelectasis has not been unified. This experiment explores the correlation between MSCT and histology in animal models of atelectasis, which is helpful for the diagnosis and treatment of obstructive atelectasis.
Methods: Forty-eight healthy adult Japanese white rabbits were randomly divided into 8 groups, 6 rabbits in each group, including control group 1 and experimental group 7. Each rabbit in the experimental group was placed with tracheobronchial stent to make atelectasis model. The MSCT values were measured and executed in the prescribed time. The atelectasis tissues were taken and sliced. The pathological changes of atelectasis in different groups were observed under light microscope. Change and analyze the correlation between them.
Results: The CT density of atelectasis increased with time. The correlation between MSCT imaging and pathological changes was as follows: alveolar collapse, alveolar interstitial capillary dilatation congestion, atelectasis density was low in the early 4 days. Inflammatory exudation occurred in the lung tissue during 7 days to 1 m, and a large number of inflammatory cells were found in the alveoli, which was obstructive pneumonia. During the occurrence period, the density value is generally between 30 and 40 Hu. After 1 month, the inflammation of lung tissue gradually alleviates. Inflammatory cells mainly concentrate around bronchioles and infiltrate intramural inflammatory cells. Cells and alveolar epithelial hyperplasia thickened. At this stage, MSCT density was above 40 Hu. Enhancement showed that atelectasis enhancement was not very uniform, and enhanced significantly at 7 and 14 days.
CONCLUSION: The best time to treat obstructive atelectasis is before bronchiectasis and bronchiectasis, and the CT value should be below 40 Hu.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R563.4;R-332
[Abstract]:Part one measurement of airway in Japanese white rabbits by spiral CT
Objective: To investigate the length, angle and correlation of various anatomical diameters of trachea and main bronchus in Japanese big-eared rabbits, and to lay a foundation for the animal experimental study of stent interventional therapy for airway diseases.
Methods: 30 healthy adult Japanese rabbits were scanned by multi-slice spiral CT. The anterior and posterior diameters, left and right diameters of trachea were measured. The trachea was straightened by MSCT. The length of trachea from glottis level to carina, the inner diameter and length of left and right main bronchi and middle bronchi, and the angle between the long axis of left and right main bronchi and sagittal plane were measured.
Results: There was no difference in the diameter of each segment of the trachea and the inner diameter of the left and right pulmonary apical lobes. The inner diameter of the right main bronchus was larger than that of the left, while the length of the long axis of the right main bronchus was less than that of the left.
Conclusion: The regression equations between the diameters, lengths and angles of the left and right main bronchus can be obtained by measuring the diameters of the trachea, left and right main bronchus with multi-slice spiral CT, which is helpful to provide anatomical parameters of the trachea and bronchus in rabbits.
The second part is the establishment of animal models of obstructive atelectasis.
Objective: To explore the method of stent placement in the airway of Japanese big-eared rabbits and to evaluate the feasibility of establishing an animal model of obstructive atelectasis with tracheobronchial integrative covered stent occlusion.
Methods: Forty-two healthy adult Japanese white rabbits, male and female, weighing 1.64-3.75 kg, with an average of 2.50 kg, were randomly divided into 7 groups, namely, 2 days, 4 days, 1 w, 2 w, 1 m, 2 m, 3 m groups, with 6 rabbits in each group. Weight, white blood cell count, MSCT, etc., to determine whether the formation of obstructive atelectasis.
Results: 42 rabbit airway stents were implanted, of which 35 were successful, 3 were in poor stent position, 4 died during operation, the success rate was 83%, 3 died after operation, 2 did not form atelectasis, and the success rate of atelectasis was 74%.
Conclusion: The animal model of obstructive atelectasis was established by DSA-guided shallow anesthesia with tracheobronchial integrated covered stent implantation. The method is simple and easy to operate. The success rate of stent implantation and atelectasis formation rate are high.
The third part is a comparative study of MSCT and pathology in obstructive atelectasis animal models.
Objective: At present, endotracheal stenting has become an effective and minimally invasive method for the treatment of obstructive atelectasis, but the best time to determine the treatment of obstructive atelectasis has not been unified. This experiment explores the correlation between MSCT and histology in animal models of atelectasis, which is helpful for the diagnosis and treatment of obstructive atelectasis.
Methods: Forty-eight healthy adult Japanese white rabbits were randomly divided into 8 groups, 6 rabbits in each group, including control group 1 and experimental group 7. Each rabbit in the experimental group was placed with tracheobronchial stent to make atelectasis model. The MSCT values were measured and executed in the prescribed time. The atelectasis tissues were taken and sliced. The pathological changes of atelectasis in different groups were observed under light microscope. Change and analyze the correlation between them.
Results: The CT density of atelectasis increased with time. The correlation between MSCT imaging and pathological changes was as follows: alveolar collapse, alveolar interstitial capillary dilatation congestion, atelectasis density was low in the early 4 days. Inflammatory exudation occurred in the lung tissue during 7 days to 1 m, and a large number of inflammatory cells were found in the alveoli, which was obstructive pneumonia. During the occurrence period, the density value is generally between 30 and 40 Hu. After 1 month, the inflammation of lung tissue gradually alleviates. Inflammatory cells mainly concentrate around bronchioles and infiltrate intramural inflammatory cells. Cells and alveolar epithelial hyperplasia thickened. At this stage, MSCT density was above 40 Hu. Enhancement showed that atelectasis enhancement was not very uniform, and enhanced significantly at 7 and 14 days.
CONCLUSION: The best time to treat obstructive atelectasis is before bronchiectasis and bronchiectasis, and the CT value should be below 40 Hu.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R563.4;R-332
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