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高热胸膜固定术的疗效:大鼠腹盆腔和胸腔浆膜的对比实验研究。

Efficacy of hyperthermia pleurodesis: A comparative experimental study on serous membrane of abdominopelvic and thoracic cavities of rats.

机构信息

Department of Thoracic Surgery, Hospital Universitari de Bellvitge, Medical School, University of Barcelona, L'Hospitalet de Llobregat, Spain.

Department of Pathology, Hospital Universitari de Bellvitge, Medical School, University of Barcelona, L'Hospitalet de Llobregat, Spain.

出版信息

Cir Esp (Engl Ed). 2022 Apr;100(4):209-214. doi: 10.1016/j.cireng.2022.04.001.

Abstract

BACKGROUND

Pleurodesis is a common technique for treating the accumulation of air or liquid in the pleural space caused by pneumothorax or pleural effusion, it is based on the bounding of pleural layers through induced inflammatory lesions. There are several pleurodesis procedures.

OBJECTIVES

To test and describe the inflammatory effect of hyperthermia on the pleural and peritoneal mesothelia of rats, with the aim of testing the effectiveness of this process for inducing pleurodesis.

METHODS

35 Sprague-Dawley (male/female) rats were randomized into four treatment groups: Group A (Talc, 10 individuals); group B (control, 5 individuals); group C (hyperthermic isotonic saline, 10 individuals); and group D (filtrate air at 50°, 10 individuals). Inflammatory effect of hyperthermia was the primary outcome parameter.

RESULTS

In the talc group, minimal adhesions between both pleural and peritoneal layers were observed in seven rats. Talc produced peritoneal mesothelium inflammation and fibrosis associated to foreign body giant cells in 80% (8/10) of the sample. Furthermore, clear evidence of a granulomatous foreign-body reaction was detected. No macroscopic and/or microscopic damage was registered in the remaining three groups (control, hyperthermic, and filtrate air).

CONCLUSIONS

Talc is an excellent method for producing pleuro-peritoneal inflammatory lesions. On the contrary, hyperthermia apparently does not induce the macroscopic and microscopic damage that is required for efficient pleurodesis. Therefore, hyperthermia should not be used for pleurodesis procedures.

摘要

背景

胸膜固定术是一种治疗气胸或胸腔积液引起的空气或液体积聚的常用技术,它基于通过诱导炎症性病变使胸膜层粘连。有几种胸膜固定术程序。

目的

测试和描述热疗对大鼠胸膜和腹膜间皮的炎症作用,旨在测试该过程诱导胸膜固定术的有效性。

方法

35 只斯普拉格-道利(雄性/雌性)大鼠随机分为四组治疗:A 组(滑石粉,10 只);B 组(对照组,5 只);C 组(加热等渗盐水,10 只);D 组(50°C 下过滤空气,10 只)。热疗的炎症作用是主要的观察指标。

结果

在滑石粉组中,7 只大鼠的胸膜和腹膜层之间仅观察到最小的粘连。滑石粉导致 80%(8/10)的样本中腹膜间皮炎症和与异物巨细胞相关的纤维化。此外,还检测到明显的肉芽肿性异物反应。其余三组(对照组、热疗组和过滤空气组)未记录到明显的宏观和/或微观损伤。

结论

滑石粉是产生胸膜腹膜炎症病变的极好方法。相反,热疗显然不会引起有效胸膜固定术所需的宏观和微观损伤。因此,不应将热疗用于胸膜固定术程序。

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