国产支气管活瓣消除支气管胸膜瘘引发的气胸动物实验

Domestic bronchial valves for eliminating pneumothorax caused by bronchopleural fistula in Bama pigs

背景支气管活瓣目前已被广泛应用于肺减容、持续性漏气、支气管胸膜瘘、复发性咯血和耐药性肺结核等的治疗,国内目前无同类替代上市。目的联合国内厂家生产一款支气管活瓣并通过其消除支气管胸膜瘘引发的气胸动物实验初步验证其有效性。方法6只巴马小型猪在全麻下右侧开胸,破坏右肺中叶支气管远端造成支气管胸膜瘘,产生气胸后留置1根胸腔闭式引流管,连接胸腔闭式引流瓶后关闭胸腔。通过支气管镜在右肺中叶支气管开口放置1枚国产支气管活瓣,漏气消除后拔除胸管。结果气胸构建成功,在右肺中叶支气管开口放置支气管活瓣后漏气平均持续时间为4.2 min。术后无手术并发症,1.5个月后复查支气管镜,2只巴马小型猪的支气管活瓣脱落,4只巴马小型猪的支气管活瓣仍正确在位工作。结论国产支气管活瓣可及时有效地消除支气管胸膜瘘产生的气胸,具有良好的临床应用前景。

Background Bronchial valves have been widely used in lung volume reduction,persistent air leakage,bronchopleural fistula,recurrent hemoptysis and drug-resistant tuberculosis.However,there is no similar alternative listing in China.Objective To produce a domestic bronchial valve and preliminarily verify its effectiveness through an animal experiment of eliminating pneumothorax caused by bronchopleural fistula.Methods Six Bama miniature pigs underwent right thoracotomy under general anesthesia to destroy the distal bronchus of the right middle lung,resulting in bronchopleural fistula.After pneumothorax,a closed thoracic drainage tube was retained,and the thoracic cavity was closed after connecting to the closed thoracic drainage bottle.A domestic bronchial valve was placed at the bronchial opening of the middle lobe of the right lung through bronchoscope,and the chest tube was removed after the air leakage was eliminated.Results The pneumothorax was successfully constructed.The average duration of air leakage after placing the bronchial valve at the bronchial opening of the middle lobe of the right lung was 4.2 min.There were no postoperative complications.After one month and a half,the bronchoscope was rechecked.The bronchial valve of 2 pigs fell off,and the other were still working correctly.Conclusion Domestic bronchial valve can effectively eliminate pneumothorax caused by bronchopleural fistula in time,with a good prospect of clinical application.