Bartholomé W, Minnigerode B
Arch Otorhinolaryngol. 1977 Dec 20;218(1-2):105-14.
In literature are only older publications about the temporal beginning of the acute atelectasis after obstructive foreign body occlusion of the bronchial system which are operated at the open thorax. For this reason experiments on animals were made to find out the earliest beginning of an atelectasis by a simple bronchial occlusion as an imitation of a natural process of a foreign body aspiration. The alterations in each single phase of development showed regularly based on serial radiographies and by the autopsy macroscopic and microscopic that about 2 or 3 h after aspiration of an obstructive foreign body it will be reckoned with a complete atelectasis. Only now correlate the clinical result, the X-ray and the pathological-anatomical alterations. The histological picture of the complete atelectasis follows the macroscopic result only in longer temporal distance. Atelectasis occuring before the mentioned moment cannot be explained by an absorption of air from the alveolar tissue, but they depend on foreign body independent reflexes (= reflex contraction atelectasis). In other series of experiments the retroplasia of an atelectasis showed no regularity after the release of the bronchial occlusion, as the time of development, but it is possible to say that it takes more time of retroplasia the longer the atelectasis lasts. Dependent on that the respiratory exchange was jerky into the atelectatic lung after a resting period without prefering any lobes of lungs where localised atelectatic foci remain a longer time.
文献中仅有关于支气管系统被阻塞性异物阻塞后急性肺不张的时间起始点的较旧出版物,这些病例是在开胸手术中处理的。因此,进行了动物实验,通过简单的支气管阻塞来找出肺不张的最早起始点,以此模拟异物吸入的自然过程。基于系列X线片以及尸检时的大体和显微镜观察,发育各阶段的改变规律显示,在阻塞性异物吸入后约2或3小时,可认为会出现完全性肺不张。直到现在才将临床结果、X线表现和病理解剖改变联系起来。完全性肺不张的组织学表现仅在较长时间间隔后才与大体结果相符。在上述时间点之前出现的肺不张不能用肺泡组织内空气吸收来解释,而是取决于与异物无关的反射(=反射性收缩性肺不张)。在其他系列实验中,支气管阻塞解除后肺不张的消退在时间发展上没有规律,但可以说肺不张持续时间越长,消退所需时间就越长。据此,在一段静止期后,呼吸交换急促地进入肺不张的肺,且不偏向任何存在局部肺不张灶且持续时间较长的肺叶。