Shah Manish D, Nguyen Lily H P, Campisi Paolo, James Adrian, Taylor Glenn P, Forte Vito
Department of Otolaryngology Head & Neck Surgery, The Hospital for Sick Children, 555 University Avenue, The University of Toronto, Toronto, Ontario, Canada M5G 1X8.
Int J Pediatr Otorhinolaryngol. 2007 Sep;71(9):1399-406. doi: 10.1016/j.ijporl.2007.05.019. Epub 2007 Jul 5.
(1) To develop a practical animal model of endolaryngeal damage secondary to prolonged endotracheal intubation. (2) To demonstrate the contribution of chronic hypoxia to laryngeal injury in the context of this model.
Four Sus scrofa piglets were anaesthetized and intubated for 24h. Two animals were maintained in a state of constant hypoxia (pO(2)<60 mmHg) while two others were ventilated with 100% oxygen. Prior to sacrifice, fluorescein dye was infused intravenously to highlight areas of hypoperfusion. The larynx and trachea were then harvested for gross and histological examination.
All four specimens demonstrated areas of edema, erythema, and ulceration on gross examination. Areas of significant histological inflammation, ulceration, and necrosis involved tube-mucosa contact, in particular, the arytenoids, the interarytenoid area, and the subglottis.
This animal model represents a practical and novel means for the investigation and treatment of laryngeal injury secondary to prolonged endotracheal intubation. Significant injury to the endolarynx was evident after only 24h of intubation and the injury involved similar areas within the larynx as described in human studies. Although clinical experience suggests that chronic hypoxia is a risk factor for endolaryngeal injury, this model did not provide experimental evidence to support this observation, most likely due to the small study size.
（1）建立一种实用的长期气管插管继发喉内损伤的动物模型。（2）在该模型背景下证明慢性缺氧对喉损伤的作用。
四只小猪麻醉后插管24小时。两只动物维持在持续缺氧状态（动脉血氧分压<60 mmHg），另外两只用100%氧气通气。处死前，静脉注射荧光素染料以突出灌注不足区域。然后取下喉和气管进行大体和组织学检查。
所有四个标本在大体检查时均显示有水肿、红斑和溃疡区域。显著的组织学炎症、溃疡和坏死区域涉及气管-黏膜接触处，特别是杓状软骨、杓间区和声门下区。
该动物模型是一种用于研究和治疗长期气管插管继发喉损伤的实用且新颖的方法。仅插管24小时后，喉内就出现了明显损伤，且损伤涉及喉内与人体研究中描述相似的区域。虽然临床经验表明慢性缺氧是喉内损伤的一个危险因素，但该模型未提供实验证据支持这一观察结果，很可能是由于研究规模较小。
