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建立两种犬良性气道狭窄模型及丝裂霉素 C 对气道狭窄的影响。

Establishment of two canine models of benign airway stenosis and the effect of mitomycin C on airway stenosis.

机构信息

The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Hebei Key Laboratory of Respiratory Critical Care, Shijiazhuang, China; Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China.

The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Hebei Key Laboratory of Respiratory Critical Care, Shijiazhuang, China; Department of Pulmonary and Critical Care Medicine, Hengshui People's Hospital, Hengshui, China.

出版信息

Int J Pediatr Otorhinolaryngol. 2022 Aug;159:111205. doi: 10.1016/j.ijporl.2022.111205. Epub 2022 Jun 9.

Abstract

OBJECTIVES

Cuffed endotracheal intubation and stent implantation were employed to simulate two types of benign airway stenosis and further to analysis the different features between them from trachecscopic characteristics, gross anatomy to histopathological changes. In addition, our study explored the therapeutic effect of mitomycin C at different concentrations on granulation tissue caused by stent implantation in order to provide a new therapeutic strategy for clinical treatment of benign airway stenosis.

METHODS

Twelve beagle dogs were randomly divided into four groups, with three dogs in each group. Group A: Three beagle dogs were intubated through oral trachea after general anesthesia and cuff pressure maintained at 200 mmHg for 24 h. Group B, Group C and Group D: endotracheal coated self-expanding metal stents were placed after general anesthesia under the guidance of bronchoscope. On the Day7 after stent implantation, Group B, as control group, was injected phosphate buffer solution of 1 ml into granulation tissue at the end of stent; Group C was injected mitomycin C of 1 ml at 0.4 mg/ml and Group D was injected mitomycin C of 1 ml at 0.8 mg/ml into granulation tissue at the end of metal airway stent respectively, the same method as Group B. Bronchoscopy was used to observe tracheal lumen on the seventh day, fourteenth day and twenty-first day after modeling and pathological changes were examined on twenty-first day.

RESULTS

Two models of benign airway stenosis can be established by cuffed endotracheal intubation and stent implantation. There was tracheal rupture in the trachea cartiage ring in the cuffed endotracheal intubation group, but was't in stent implantation group. Histopathological characteristics were different between cuffed endotracheal intubation and stent implantation groups. In stent placement groups, we found that the stenosis degree of mitomycin C at 0.4 mg/ml was approximately 19%-32%, mitomycin C at 0.8 mg/ml was approximately 16%-21% and the control group was approximately 36%-47%.

CONCLUSION

The two models of canine benign tracheal stenosis induced by cuffed endotracheal intubation and stent implantation are relatively simple, reliable and reproducible and have different characteristics. Mitomycin C could inhibit proliferation of granulation tissue and attenuate the degree of airway stenosis caused by stent implantation.

摘要

目的

通过带套囊的气管插管和支架植入模拟两种类型的良性气道狭窄,并进一步从气管镜特征、大体解剖到组织病理学变化分析它们之间的不同特征。此外,我们的研究还探讨了不同浓度的丝裂霉素 C 对支架植入引起的肉芽组织的治疗效果,以期为良性气道狭窄的临床治疗提供新的治疗策略。

方法

12 只比格犬随机分为 4 组,每组 3 只。A 组:全麻后经口腔气管插管,套囊压力维持在 200mmHg 24 小时。B 组、C 组和 D 组:全麻下在支气管镜引导下置入气管内覆膜自膨式金属支架。支架植入后第 7 天,B 组(对照组)在支架末端注入 1ml 磷酸缓冲液,C 组注入 1ml0.4mg/ml 丝裂霉素 C,D 组注入 1ml0.8mg/ml 丝裂霉素 C 至金属气道支架末端的肉芽组织中,方法同 B 组。建模后第 7、14、21 天行支气管镜检查观察气管腔变化,第 21 天检查病理变化。

结果

带套囊的气管插管和支架植入均可建立良性气道狭窄模型。带套囊的气管插管组气管软骨环有气管破裂,支架植入组未见。带套囊的气管插管和支架植入组的组织病理学特征不同。在支架植入组中,我们发现 0.4mg/ml 丝裂霉素 C 的狭窄程度约为 19%-32%,0.8mg/ml 丝裂霉素 C 的狭窄程度约为 16%-21%,对照组约为 36%-47%。

结论

带套囊的气管插管和支架植入诱导犬良性气管狭窄的两种模型相对简单、可靠、可重复,且具有不同的特征。丝裂霉素 C 可抑制肉芽组织的增殖,减轻支架植入引起的气道狭窄程度。

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