国产支架支气管肺减容术在绵羊肺气肿模型中的初步应用  

Primary study on bronchoscopic lung volume reduction using one-way flap stent made in China in sheep model of heterogeneous emphysema

作　　者：范勇[1] 吴琦[2] 梁春宝[1] 李萍[1] 马景良[1] 武俊平[1] 华静娜[2] 王咏梅[1] 王金荣[1] 沈淑敏[1] 贺能树[2] 

机构地区：[1]天津市海河医院(天津市呼吸疾病研究所),天津300350 [2]天津医科大学总医院,天津300350

出　　处：《中国内镜杂志》2007年第10期1049-1051,1059,共4页China Journal of Endoscopy

基　　金：天津市卫生局2004重点课题;编号:04KY01

摘　　要：目的评价经气道国产单向活瓣支架肺减容术治疗肺气肿动物模型的放送技术和稳定性。方法应用局部气管内滴注木瓜蛋白酶方法复制6个月龄绵羊不均一肺气肿模型,经纤维支气管镜通过导丝和放送装置在肺气肿亚段放入1、2个单向活瓣支架,术后8周处死动物取出完整肺组织,在萎陷区、非萎陷区和对侧正常肺组织分别取材,观察大体及光镜下病理学改变。结果7只绵羊气肿模型,共放置支架10支,9支均成功植入。病理观察1只出现肺部炎症细胞浸润,2只植入支架处支气管壁有少量纤维母细胞、平滑肌细胞及支气管粘膜上皮细胞增生,4只未见明显异常。CT检查支架远端、肺组织大体标本和光镜下均证实存在肺不张。结论经纤维支气管镜植入单向活瓣支架行肺减容术治疗肺气肿创伤小,支架对气管壁的刺激小,可以达到外科肺减容术的效果。[Objective] To evaluate the constancy and the skill of bronchoscopic lung volume reduction using one-way flap stent made in China in sheep model of heterogeneous emphysema. [Methods] 7 sheep were treated with localized papain instillations to generate heterogeneous emphysema, subsequently underwent bronchoscopic lung volume reduction（BLVR）using 1-2 one-way flap stentsat subsegment . Animals were euthanized at the 8-week time point. Lungs were observed morphology in general and histopathology. [Results] 9 of 10 stents were successfully sent out in the 7 models. 1 of them with pneumonia and 2 with fight hyperplasy of fibroblast, smooth muscle and epithefial cells. Pulmonary closure on the lung distal end of stent was confirmed by CT in general and in microscope. [Conclusions] Bronchoscopic lung volume reduction using one-way flap stent is a minimally invasive procedure and the stimulus of the devices to walls of bronchi is slight, moreover, the technique may attain effectiveness of surgery. Therefore it may be a perspective treatment of COPD.

关 键 词：支气管镜下肺减容术 单向活瓣支架 肺气肿 

分 类 号：R563.3[医药卫生—呼吸系统] R332[医药卫生—内科学]