经支气管镜肺减容术的初探

Pilot study on bronchoscopic lung volume reduction

目的探讨应用支气管封堵液经支气管镜肺减容术(BLVR)的方法及可行性。方法成年杂种犬18只,随机分成3组,每组6只,分成组织封闭剂组、四环素组和仅行支气管镜操作组。术后采用影像学(CT)、尸检、病理学(HE染色、免疫组化染色)、RT-PCR及WB方法检测靶段肺组织情况。结果所有实验犬均耐受此手术,无动物死亡,术后无明显并发症;组织封闭剂组和四环素组的靶段肺组织被瘢痕组织替代,且组织封闭剂应用于BLVR优于四环素,行支气管镜操作组未见异常。结论应用组织封闭剂经支气管镜肺减容术操作容易,创伤小,并发症少,可用于肺减容治疗。

Objective To investigate the possibility and method of bronchoscopic lung volume reduction（BLVR） with polymers. Methods The animals were divided into three treatment groups of six animals,and underwent BLVR using tissue sealant,BLVR using tetracycline, or bronchoscopy alone. Target lung was detected by roentgenographic examination and histopathological methods. RT-PCR and WB were used to detect the expression of TGF-β1 and CTGF. Results No animal was dead,and no complications were observed. The two groups of BLVR using tissue sealant and tetracycline were found scar tissue substitute target lung at 8 week and 12 week postoperation respectively. And tissue s.ealant was more suitable than tetracycline in BLVR. The six dogs of bronchoscopy alone were healthy. Conclusion Operative procedure through bronchoscopic lung volume reduction using tissue sealant is easy,trauma is little,complications are few. So this method will be used in the therapy of lung volume reduction.