博来霉素-碘化油乳剂犬支气管栓塞的实验研究

The experimental study of intra-bronchus embolization of bleomycin-lipiodol emulsion in dogs

目的:探讨应用博来霉素碘化油乳剂实现功能性肺叶切除(functionalpulmonarylobectomy,FPLT)的可能性。方法:8条杂种犬,左、右两肺分别随机纳入实验组和对照组。实验组行靶肺叶灌注博来霉素 碘化油乳剂,然后阻塞靶气管。观察术后1h及第7、14、2 1和2 8天双肺X线平片和病理变化。结果:术后第1天,实验组靶肺间质水肿,伴大量炎性细胞浸润,以中性粒细胞和淋巴细胞为主,多数肺泡毛细血管内微血栓形成;自术后第7天,靶肺肺泡明显塌陷,肺泡间隔增宽,纤维结缔组织显著增殖;术后第2 8天靶肺萎缩成团块状,剖面呈弥漫性纤维化斑痕改变。结论:博来霉素碘化油乳剂靶肺气道栓塞术可形成肺不张、纤维化,达到FPLT目的。

Objective:To investigate the possibility of using bleomycin-lipiodol emulsion (BLE) as an agent for functional pulmonary lobectomy (FPLT).Methods:The bilateral lungs of eight healthy mongrel dogs were randomly divided into the control group and the FPLT group.In FPLT group the target pulmonary lobes were distilled with BLE and then the target bronchi were occluded.In Control group the pulmonary lobes were done with nothing.The dogs were took X-ray films pre-procedure and post-procedure and then on 1st,7th,14th,21st and 28th days respectively,some of them were sacrificed after procedure for histopathological examination.Results:Histopathologically the target pulmonary lobes were mainly inflammatory effusion on first day.After seven days the alveoli collapsed,pulmonary interstitium widend and fibrous connective tissue proliferated.After twenty-eight days the target pulmonary lobes were atelectasis and its pulmonary parenchyma was fibrosed evidently after procedure.Conclusion:Intra-bronchus embolization of bleomycin-lipiodol emlusion can result in atelectasis and fibrosis of the target pulmonary lobes.So it is a save and effective method for achieving FPLT.