Gade J, Qvortrup K, Andersen C B, Thorsen S, Svendsen U G, Olsen P S
Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark.
Scand Cardiovasc J. 2001 Jul;35(3):212-20. doi: 10.1080/140174301750305117.
The lungs have dual blood supply: The bronchial and the pulmonary circulation. The importance of bronchial circulation is disputed. The purpose of this study was to establish an experimental model to examine the importance of the bronchial artery.
Comparative porcine experimental study. The surgical technique was evaluated in group A (n = 9). Group B (n = 8) underwent left bronchial arterial devascularization. In group C (n = 9) the left principal bronchus was devascularized, transsected, and reanastomosed. In groups B and C bronchial mucosal blood flow was studied with laser-Doppler velocimetry. Devascularization was controlled by angiography at section, and specimens were examined with conventional histology and scanning electron microscopy. The right bronchus served as control.
In group B devascularization caused considerable, yet insignificant reduction in bronchial mucosal blood flow index (p = 0.1282) postoperatively, and after 1 week (p = 0.0678), insignificant histologic (p > 0.2) changes, and no scanning electron microscopy differences. In group C devascularization with bronchial transsection caused significant reduction in mucosal blood flow index (p = 0.0277) postoperatively and after 1 week (p = 0.0277), significant histologic changes (p = 0.0277), and insignificant (p = 0.069) changes in scanning electron microscopy.
Bronchial arterial devascularization with transsection caused significant physiologic and morphologic changes, and a model with bronchial devascularization should include transsection.
肺有双重血液供应,即支气管循环和肺循环。支气管循环的重要性存在争议。本研究的目的是建立一个实验模型来检验支气管动脉的重要性。
猪的对比实验研究。对A组(n = 9)的手术技术进行评估。B组(n = 8)进行左支气管动脉去血管化。C组(n = 9)对左主支气管进行去血管化、横断并重新吻合。用激光多普勒血流仪研究B组和C组的支气管黏膜血流。在切片时通过血管造影控制去血管化情况,并用传统组织学和扫描电子显微镜检查标本。右侧支气管作为对照。
在B组,去血管化术后导致支气管黏膜血流指数有相当程度但不显著的降低(p = 0.1282),1周后(p = 0.0678),组织学变化不显著(p > 0.2),扫描电子显微镜检查无差异。在C组,支气管横断的去血管化术后导致黏膜血流指数显著降低(p = 0.0277),1周后(p = 0.0277),组织学变化显著(p = 0.0277),扫描电子显微镜检查变化不显著(p = 0.069)。
支气管横断的去血管化导致显著的生理和形态学变化,支气管去血管化模型应包括横断。