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实验性肺萎陷在自行扩张型支气管封堵器在兔模型中的应用。

Experimental lung collapse following deployment of a self-expandable bronchial occluder in a rabbit model.

机构信息

Department of Radiology, Eulji Medical Center, University of Eulji College of Medicine, Seoul, Republic of Korea.

出版信息

Br J Radiol. 2012 Jun;85(1014):e146-52. doi: 10.1259/bjr/40247893. Epub 2011 Mar 8.

Abstract

OBJECTIVES

Closure of a bronchopleural fistula is required to prevent fatal empyema or aspiration pneumonia. The purpose of this study was to determine the feasibility and efficacy of bronchial occlusion with a self-expandable occluder to induce experimental lung collapse in a rabbit model.

METHODS

10 bronchial occluders (wine glass appearance; 8 mm in diameter and 15 mm in length) were implanted in the native left main bronchi of 10 rabbits via an endotracheal route. We analysed the following: (1) diameters and morphological changes of the bronchial occluders during follow-up; (2) percentage volume of the collapsed lung during follow-up; and (3) complications and gross pathology. 1-day and 2-week follow-up CT scans were routinely obtained. Rabbits were sacrificed 4 weeks after the experiment.

RESULTS

In all 10 rabbits, the bronchial occluders were successfully implanted and were completely expanded within 2 weeks. Complete collapse of the left lung occurred in three rabbits on day 1 and in an additional two rabbits 2 weeks following implantation. Two other rabbits maintained the percentage volume of the collapsed lung between 51% and 99% during follow-up; the other three rabbits had <50% during follow-up. Pneumothoraces occurred in nine rabbits, but completely resolved at the 2-week follow-up. Right lung herniation across the midline progressed 2 weeks after occluder implantation.

CONCLUSION

Placement of self-expandable occluders in a rabbit bronchus model was feasible and showed a potential to induce artificial lung collapse. While pneumothoraces were common, they resolved during follow-up.

摘要

目的

为了防止致命性脓胸或吸入性肺炎,需要对支气管胸膜瘘进行闭合。本研究旨在确定使用自膨式封堵器对支气管进行封堵以在兔模型中诱导实验性肺萎陷的可行性和有效性。

方法

通过气管内途径将 10 个支气管封堵器(酒杯状;直径 8 毫米,长 15 毫米)植入 10 只本地左主支气管。我们分析了以下方面:(1)在随访过程中支气管封堵器的直径和形态变化;(2)在随访过程中萎陷肺的体积百分比;和(3)并发症和大体病理学。常规获得 1 天和 2 周的随访 CT 扫描。实验后 4 周处死兔子。

结果

在所有 10 只兔子中,支气管封堵器均成功植入,2 周内完全扩张。3 只兔子在第 1 天,另外 2 只兔子在植入后 2 周完全发生左肺萎陷。另外 2 只兔子在随访过程中保持萎陷肺的体积百分比在 51%至 99%之间;另外 3 只兔子在随访过程中<50%。9 只兔子发生气胸,但在 2 周随访时完全缓解。右肺疝越过中线在封堵器植入后 2 周进展。

结论

在兔支气管模型中放置自膨式封堵器是可行的,并且显示出诱导人工肺萎陷的潜力。虽然气胸很常见,但在随访过程中会得到解决。

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