【目的】改进和优化ABS血管铸型技术。创建猪支气管动脉立体标本的铸型方法,并构建猪支气管动脉立体标本。为探明猪支气管动脉在肺内的分支与分布状态提供实验方法。【方法】用改进和优化ABS铸型技术,采用支气管动脉单纯铸型和支气管动...【目的】改进和优化ABS血管铸型技术。创建猪支气管动脉立体标本的铸型方法,并构建猪支气管动脉立体标本。为探明猪支气管动脉在肺内的分支与分布状态提供实验方法。【方法】用改进和优化ABS铸型技术,采用支气管动脉单纯铸型和支气管动脉与支气管树或肺动脉联合铸型的方法构建猪支气管动脉的立体标本。【结果】(1)创建了猪支气管动脉立体标本的铸型方法。1猪肺支气管动脉单纯标本制作的方法要点:先分别在胸主动脉近心端和远心端插管并结扎胸主动脉。同时,为了防止在灌入铸型剂时经食管和气管周围的血管网发生渗漏,分别在胸主动脉插管处相应的位置结扎食管前端和后端,并在气管开口处插入盲端套管并结扎。然后调整肺的位置,使其背上腹下地置于解剖盘中。经胸主动脉间接向支气管动脉中注入铸型剂。灌注时强压梯度灌入60 mL 10%和100-160 mL 15%的ABS铸型剂,当橡胶管中间部位膨大后停止灌注。在连续灌注结束后5 h内随时观察橡胶管膨大部位的大小,当压力减小时,立即灌入20%的ABS铸型剂,保证主动脉内的正压力。将灌注好的标本置于冷水中静态硬化3-4 d,再用盐酸密闭腐蚀10 d左右。然后用流水漂浮和加压冲洗,再通过摘除凝块、打枝疏密和断枝再植修整后就可以获得完整的铸型标本。2猪肺支气管动脉与支气管树联合铸型标本制作的方法要点:首先,同时插管并结扎胸主动脉、食管和气管。然后经胸主动脉间接灌注铸型剂。间隔1-2 h后再对气管树进行灌注。最后同步硬化、腐蚀、冲洗和修复支气管动脉与支气管树联合标本。3猪肺支气管动脉与肺动脉联合铸型标本制作的方法要点:支气管动脉与支气管树联合铸型的方法和支气管动脉与肺动脉联合铸型的方法相似,不同之处在于在将铸型剂注入支气管动脉的同时,前者是将铸型剂注入支气管树内,后者则是将铸型剂注入肺动脉内。在联合铸型时,根据肺的大小确定注入铸型剂的量,而经支气管动脉单纯铸型时,则根据压力大小确定灌注量。(2)构建了猪支气管动脉立体标本、猪支气管动脉与猪支气管树的联合立体标本和猪支气管动脉与肺动脉的联合标本。【结论】采用该方法获得的支气管动脉立体标本血管层次清楚、管道充盈光滑、对比度清晰,能够完整显示猪支气管动脉的起源、分支、走向、分布以及与支气管树和肺动脉的毗邻关系。该工作为猪及其它动物支气管动脉的研究奠定了基础。展开更多
BACKGROUND Plastic bronchitis(PB)frequently occurs in children after the surgical repair of congenital cardiac defects or in the presence of inflammatory or allergic diseases of the lung.Accurate epidemiological data ...BACKGROUND Plastic bronchitis(PB)frequently occurs in children after the surgical repair of congenital cardiac defects or in the presence of inflammatory or allergic diseases of the lung.Accurate epidemiological data of this condition are still lacking.CASE SUMMARY A 5-year-old boy,with a clear medical history,presented to our hospital with persistent cough and pneumonia with segmental atelectasis on chest computerized tomography.He showed no significant improvement after 1 wk of amoxicillin-clavulanate potassium treatment.Bronchial casts were extracted using flexible bronchoscopy.Pathological examination of the dendritic cast confirmed the diagnosis of type I PB.Botrytis cinerea was detected by next-generation sequencing of the bronchoalveolar lavage fluid.After the removal of the airway obstruction and fluconazole treatment,the patient recovered and was discharged 14 d after admission without the recurrence of cough.CONCLUSION Botrytis cinerea pneumonia should be considered in children with PB who still have prolonged cough and atelectasis after a regular course of antibiotic therapy.Flexible bronchoscopy and etiological examination should be performed in a timely manner to determine the diagnosis,clear the airway obstruction,and target etiological treatment.展开更多
文摘【目的】改进和优化ABS血管铸型技术。创建猪支气管动脉立体标本的铸型方法,并构建猪支气管动脉立体标本。为探明猪支气管动脉在肺内的分支与分布状态提供实验方法。【方法】用改进和优化ABS铸型技术,采用支气管动脉单纯铸型和支气管动脉与支气管树或肺动脉联合铸型的方法构建猪支气管动脉的立体标本。【结果】(1)创建了猪支气管动脉立体标本的铸型方法。1猪肺支气管动脉单纯标本制作的方法要点:先分别在胸主动脉近心端和远心端插管并结扎胸主动脉。同时,为了防止在灌入铸型剂时经食管和气管周围的血管网发生渗漏,分别在胸主动脉插管处相应的位置结扎食管前端和后端,并在气管开口处插入盲端套管并结扎。然后调整肺的位置,使其背上腹下地置于解剖盘中。经胸主动脉间接向支气管动脉中注入铸型剂。灌注时强压梯度灌入60 mL 10%和100-160 mL 15%的ABS铸型剂,当橡胶管中间部位膨大后停止灌注。在连续灌注结束后5 h内随时观察橡胶管膨大部位的大小,当压力减小时,立即灌入20%的ABS铸型剂,保证主动脉内的正压力。将灌注好的标本置于冷水中静态硬化3-4 d,再用盐酸密闭腐蚀10 d左右。然后用流水漂浮和加压冲洗,再通过摘除凝块、打枝疏密和断枝再植修整后就可以获得完整的铸型标本。2猪肺支气管动脉与支气管树联合铸型标本制作的方法要点:首先,同时插管并结扎胸主动脉、食管和气管。然后经胸主动脉间接灌注铸型剂。间隔1-2 h后再对气管树进行灌注。最后同步硬化、腐蚀、冲洗和修复支气管动脉与支气管树联合标本。3猪肺支气管动脉与肺动脉联合铸型标本制作的方法要点:支气管动脉与支气管树联合铸型的方法和支气管动脉与肺动脉联合铸型的方法相似,不同之处在于在将铸型剂注入支气管动脉的同时,前者是将铸型剂注入支气管树内,后者则是将铸型剂注入肺动脉内。在联合铸型时,根据肺的大小确定注入铸型剂的量,而经支气管动脉单纯铸型时,则根据压力大小确定灌注量。(2)构建了猪支气管动脉立体标本、猪支气管动脉与猪支气管树的联合立体标本和猪支气管动脉与肺动脉的联合标本。【结论】采用该方法获得的支气管动脉立体标本血管层次清楚、管道充盈光滑、对比度清晰,能够完整显示猪支气管动脉的起源、分支、走向、分布以及与支气管树和肺动脉的毗邻关系。该工作为猪及其它动物支气管动脉的研究奠定了基础。
文摘BACKGROUND Plastic bronchitis(PB)frequently occurs in children after the surgical repair of congenital cardiac defects or in the presence of inflammatory or allergic diseases of the lung.Accurate epidemiological data of this condition are still lacking.CASE SUMMARY A 5-year-old boy,with a clear medical history,presented to our hospital with persistent cough and pneumonia with segmental atelectasis on chest computerized tomography.He showed no significant improvement after 1 wk of amoxicillin-clavulanate potassium treatment.Bronchial casts were extracted using flexible bronchoscopy.Pathological examination of the dendritic cast confirmed the diagnosis of type I PB.Botrytis cinerea was detected by next-generation sequencing of the bronchoalveolar lavage fluid.After the removal of the airway obstruction and fluconazole treatment,the patient recovered and was discharged 14 d after admission without the recurrence of cough.CONCLUSION Botrytis cinerea pneumonia should be considered in children with PB who still have prolonged cough and atelectasis after a regular course of antibiotic therapy.Flexible bronchoscopy and etiological examination should be performed in a timely manner to determine the diagnosis,clear the airway obstruction,and target etiological treatment.
