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高选择性迷走神经切断术治疗犬哮喘。

Treatment of canine asthma by high selective vagotomy.

机构信息

State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Cardiothoracic Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

J Thorac Cardiovasc Surg. 2014 Aug;148(2):683-9. doi: 10.1016/j.jtcvs.2013.12.041. Epub 2014 Jan 15.

Abstract

OBJECTIVES

This study evaluated the effect of high selective bilateral vagotomy of hilus pulmonis with video-assisted thoracoscopy on asthma.

METHODS

Eight dogs with skin sensitive to Ascaris suum antigens were randomly divided into groups A and B. Asthma was induced by aerosol inhalation of A suum antigens. Respiratory rate and peak airway pressure were significantly increased (P < .05) in both groups. Dynamic compliance was dramatically increased (P < .05) in both groups. Two days later, bilateral vagotomy of hilus pulmonis under thoracoscopic guidance was performed on dogs in group A; dogs in group B underwent bilateral sham vagotomy plus thoracoscopy. Five days after treatment, all dogs had rechallenge with a second aerosol inhalation.

RESULTS

Dogs in group A did not show typical asthmatic symptoms, and no significant changes were found in respiratory rate, peak airway pressure, and dynamic compliance (P > .05). Dogs in group B still had typical symptoms, and respiratory rate and peak airway pressure were increased and dynamic compliance decreased significantly (P < .05 for all). Significant differences in respiratory rate, peak airway pressure, and dynamic compliance were observed between groups. Moreover, inflammatory cells in the lungs and bronchoalveolar lavage fluid of group A were dramatically reduced relative to group B (P < .05). There were no significant changes in heart rate and mean arterial pressure after vagotomy, indicating that vagotomy did not affect the cardiac plexus of vagus.

CONCLUSIONS

High selective bilateral vagotomy of hilus pulmonis with thoracoscope can effectively control asthma in dogs.

摘要

目的

本研究评估了电视辅助胸腔镜下肺门高位双侧迷走神经切断术对哮喘的影响。

方法

将 8 只对猪蛔虫抗原敏感的犬随机分为 A 组和 B 组。通过雾化吸入猪蛔虫抗原诱导哮喘。两组的呼吸频率和气道峰压均显著升高(P<.05),动态顺应性也显著升高(P<.05)。两组犬在第 2 天均在胸腔镜引导下行肺门高位双侧迷走神经切断术,A 组犬行双侧假迷走神经切断术加胸腔镜检查。治疗 5 天后,所有犬均再次进行第二次雾化吸入。

结果

A 组犬未出现典型哮喘症状,呼吸频率、气道峰压和动态顺应性均无明显变化(P>.05)。B 组犬仍有典型症状,呼吸频率和气道峰压升高,动态顺应性明显降低(P<.05)。两组间呼吸频率、气道峰压和动态顺应性均有显著差异。此外,与 B 组相比,A 组犬的肺部炎症细胞和支气管肺泡灌洗液明显减少(P<.05)。迷走神经切断术后心率和平均动脉压无明显变化,提示迷走神经切断术不影响迷走神经心丛。

结论

电视辅助胸腔镜下肺门高位双侧迷走神经切断术能有效控制犬哮喘。

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