单向活瓣肺减容术的CT和肺功能评价

CT and pulmonary function evaluation of one-way valve lung volume reduction

目的探讨单向活瓣肺减容术治疗效果的无创评价方法。方法Beagle犬7只，雄性4只，雌性3只，2岁，体质量12～16kg。将其制备成肺气肿动物模型后，在其右肺置入平均3枚自行设计活瓣，2个月后对其行胸部CT和肺功能检查。结果除2枚活瓣被咳出外，其余19枚活瓣均未移位。胸部CT显示置入活瓣的相应肺叶有肺炎、肺纤维化表现。功能残气量（FRC）、肺总量（TLC）、功能残气量比肺总量（FRC／TLC％）、潮气量（VT）和呼吸频率（RF），造模后高于造模前（P〈0．05）；单向活瓣置入术后2个月VT、FRC、TLC低于造模后（P〈0．01），FRC／TLC％和RF两者间差异无统计学意义（P〉0．05）；术后2个月FRC／TLC％和RF高于造模前（P〈0．05），VT、FRC、TLC两者间差异无统计学意义（P〉0．05）。结论胸部CT和肺功能检查对评价早期单向活瓣置入肺减容是一种较为敏感、安全无创和有效的方法。

Objective To discuss the effect of one-way valve in treatment of lung volume reduction as a non-invasive evaluation method. Methods Seven Beagle dogs,male four and female three,2-years old,body mass 12-16 kg. The average placements in the animal models of emphysema were right lung three valves designed by our own. Two months later animals were checked up by chest CT and pulmonary function. Results Apart from the two valves coughed up,the remaining 19 did not shift the location. CT revealed the corresponding lung lobe implanted valve had pneumonia, pulmonary fibrosis. In functional residual capacity （FRC）, total lung capacity（ TLC）, FRC/TLC G, tidal volume （ VT ） and respiratory frequency （ RF）, the model of emphysema was statistically different between before and after making model（ P〈0.05）;the model of emphysema （after making model） and two months after surgery VT, FRC,TLC was statistically different（ P〈0.01） ,FRC/TLC% and RF had no statistical significance（ P〈0.05） ;two months after surgery FRC/TLC% and RF were significantly higher than those before making model （ P % 0.05）, VT, FRC, TLC had no statistical difference（ P〈0.05）. Conclusions Chest CT and pulmonary function check is a more sensitive, safe, noninvasive and effective method for early evaluation of one-way valve in treatment of lung volume reduction.