Keskin Yasin, Bedel Cihan, Gökben Beceren Nesrin
Beyhekim State Hospital, Department of Emergency Medicine, Konya, Turkey.
Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.
Iran J Basic Med Sci. 2019 Oct;22(10):1153-1157. doi: 10.22038/ijbms.2019.32357.8258.
Pulmonary contusion (PC) is a clinical entity that often accompanies blunt traumas. We aimed to investigate the radiological and histopathological effects of surfactant treatment in an experimental rat model in which lung contusion was formed by blunt thoracic trauma.
50 female Sprague-Dawley rats were used. Five groups were formed randomly. In groups 2, 4, and 5 lung contusion was made by the drop-weight method after anesthesia. Intratracheal surfactant was administered in the 4th hr in groups 3 and 4 and in the 24th hr in groups 4 and 5. All rats were sacrificed and their lungs removed at 48 hr after contusion. Alveolar edema, congestion, hemorrhage, destruction, leukocyte infiltration, immune staining were examined histopathologically.
When the first thoracic CT scans were evaluated, we observed two rats with rib fractures and four rats with pneumothorax. 4 and 48 hr thoracic CT evaluation contusion and atelectasis showed no statistically significant decrease (>0.05). After sacrifice of group 2, in macroscopic evaluation, there was a heterogeneous contusion and hemorrhagic appearance in the lungs of rats and less hemorrhagic appearance was observed in Groups 4 and 5 than in Group 2. In comparison of Immunohistopathological findings, surfactant treatment showed a statistically significant decrease in leukocyte infiltration scores (=0.046). Immunohistopathologically, surfactant group had more staining but only statistically significant when compared to groups 4 and sham. (=0.036).
Surfactant treatment may be of significant benefit in lung contusion secondary to blunt chest trauma, and further prospective evidence of its efficacy in such disorders is needed.
肺挫伤（PC）是一种常伴随钝性创伤的临床病症。我们旨在研究在通过钝性胸部创伤形成肺挫伤的实验大鼠模型中，表面活性剂治疗的放射学和组织病理学效果。
使用50只雌性Sprague-Dawley大鼠。随机分为五组。第2、4和5组在麻醉后通过坠重法造成肺挫伤。第3和4组在伤后4小时给予气管内表面活性剂，第4和5组在伤后24小时给予。所有大鼠在挫伤后48小时处死并取出肺脏。对肺泡水肿、充血、出血、破坏、白细胞浸润、免疫染色进行组织病理学检查。
在评估首次胸部CT扫描时，我们观察到2只大鼠有肋骨骨折，4只大鼠有气胸。伤后4小时和48小时的胸部CT评估显示挫伤和肺不张无统计学显著降低（>0.05）。第2组大鼠处死后，宏观评估显示大鼠肺脏有不均匀挫伤和出血表现，第4和5组的出血表现比第2组少。比较免疫组织病理学结果，表面活性剂治疗显示白细胞浸润评分有统计学显著降低（=0.046）。免疫组织病理学方面，表面活性剂组染色更多，但与第4组和假手术组相比仅在统计学上有显著差异（=0.036）。
表面活性剂治疗可能对钝性胸部创伤继发的肺挫伤有显著益处，需要进一步的前瞻性证据证明其在此类病症中的疗效。
