博莱霉素-碘化油乳剂栓塞犬支气管的病理研究

The Histopathological Study of Intrabronchus Embolization with Bleomycin Lipiodol Emulsion in Dogs

目的探讨应用博莱霉素-碘化油乳剂实现功能性肺叶切除(FPLT)的可能性。材料与方法16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莱霉素-碘化油乳剂,然后阻塞靶气管。观察术后1h及第7、14、21和28d双肺X线平片和病理变化。结果术后第1d,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;至术后第7d,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28d靶肺萎缩成团块状,剖面呈弥漫性纤维化瘢痕改变。结论博莱霉素-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 discuss the possibility of bleomycin lipiodol emulsion （BLE） as an agent for functional pulmonary lobectomy. Materials and Methods The bilatersl lungs of 16 healthy mongrel dogs were randomly divided into Control group and the FPLT group. In FPLT group the target pulmonary lobes were filled with BLE and then the target bronchi were occluded. In Control group the pulmonary lobes were done with nothing. The dogs were taken X-ray films and pathological changes on 1st, 7th, 14th, 21st, and 28th days after embolization respectively. Results Histopathological results showed that the target pulmonary lobes were mainly in flammatory effusion on first day. After 7 days the alveoli collapsed and pulmonary interstitium widened and fibrous connective tissue proliferated. After 28 days the target pulmonary lobes were atelectasis and its pulmonary parenchyma was fibrosis diffusely after embolization. Conclusion Intrabronchus embolization with bleomycin lipiodol emulsion can result in atelectasis and fibrosis of the target pulmonary lobes, so it is an effective method for achieving FPLT.