均质性肺气肿经支气管镜单向活瓣肺减容术研究

目的探索经支气管镜单向活瓣肺减容术对均质性肺气肿的治疗效果。方法均质性肺气肿Beagle犬7只,在动物右肺经支气管镜置入2～4枚支气管单向活瓣,2个月后处死实验动物,进行大体标本观察,光镜病理学评价及电子计算机图像定量分析,并与基本情况相似的正常犬和肺气肿模型犬进行比较,评价疗效。结果共置入21枚活瓣,除2枚活瓣咳出外,余19枚活瓣均未移位。实验动物无明显不良反应。观察大体标本发现单向活瓣阻塞的肺叶缩小、质地较硬,脏层胸膜有局灶瘢痕形成,支气管壁周围有少许组织增生;周围肺叶无出血、实变。病理学观察及图像分析结果示7只实验犬被阻塞的肺叶均有中度肺泡炎及肺间质纤维化表现。图像定量分析结果显示,与肺气肿模型犬比较,7只实验犬有明显肺泡陷闭、肺容积缩小表现（P〈0.01）,与正常犬比较也有肺泡陷闭、肺容积缩小表现（P〈0.05）。结论单向活瓣肺减容术对均质性肺气肿犬的治疗在一定程度上是有效的。

Effects of bronchoscopic lung volume reduction using one-way valve on homogeneous emphysema

Objective To explore the treatment effects of one-way valve bronchoscopic lung volume reduction for heterogeneous emphysema.Methods Seven heterogeneous emphysema Beagle dogs were each implanted in right lung 2-4 pieces of bronchial one-way valve.The animals were sacrificed two months later.Macro-and microscopic pathology changes of the lungs were observed.Results Of 21 valves implanted,2 were expectorated,and 19 were in previous normal position.The dogs did not have obvious adverse reactions.Generally specimens of the occluded lobes had different levels of lung volume decrease,such as texture stiffened,focal scar formation,atelectasis,pulmonary fibrosis.Pathological biopsy showed moderate alveolitis and pulmonary interstitial fibrosis.Conclusion One-way valve lung volume reduction is effective for heterogeneous emphysema.