肺气肿兔单侧肺减容术后的肺功能及组织结构变化

Changes of pulmonary function and histology in emphysematous rabbit after single side lung volume reduction surgery

目的 评价阻塞性肺气肿兔单侧肺减容术 (LVRS)后的肺功能和组织结构变化 ,并与肺叶切除术比较。方法 4 0只新西兰大白兔采用烟熏和气管内滴注弹性蛋白酶制成阻塞性肺气肿模型 ,随机分为肺气肿组 (A组 )、单侧LVRS组 (B组 )、肺叶切除组 (C组 )和假手术组 (D组 ) ,每组 10只。 8周后进行肺功能和肺组织学检查。结果 与A组比较 ,B组和C组的潮气量、0 3秒用力呼气容积 (FEV0 3)、FEV0 3 FVC(用力肺活量 )、PaO2 、平均肺泡数和肺泡隔面密度增加 ,功能残气量、PaCO2 、肺总容积和肺泡直径降低 (P <0 0 5 ) ,而D组变化不明显 (P >0 0 5 )。B组和C组肉眼及光镜下可见肺气肿改善 ,而D组无明显变化。B组和C组之间上述各指标差异无显著性 (P >0 0 5 )。

Objective To evaluate the changes of pulmonary function and histology in emphysematous rabbits after lung volume reduction surgery (LVRS) and compare with those after lobectomy. Methods Obstructive emphysema was induced in 40 New Zealand white rabbits with smog and elastase, and the emphysematous rabbits were randomly and equally divided into four groups: control group (group A), single side LVRS group (group B), lobectomy group (group C) and sham operation group (group D). Eight weeks later, pulmonary functions, artery blood gas analysis and pulmonary histology were observed. Results Compared with group A, vital volume (VT), forced expiratory volume within 0.3 second (FEV 0.3 ), FEV 0.3 /FVC (forced vital capacity), PaO 2, density of alveolar septum (Ds) and number of alveolus (Na) increased postoperatively, but PaCO 2, total lung capacity (TLC), functional residual capacity (FRC) and diameter of alveolus (Da) decreased in group B and group C (P<0.05). There was no obvious change in group D (P>05). Meanwhile, there was no difference between group B and group C (P>0.05). Morphological changes of obstructive emphysema were noticed under naked eyes and optical microscope in group B and group C, while no above changes were observed in group D. Conclusion Both single side LVRS and lobectomy can effectively improve the pulmonary function and histology of emphysematous rabbits.