单侧肺减容术肺切除量对兔阻塞性肺气肿疗效的影响

目的　评价单侧肺减容术 (LVRS)肺切除量对兔阻塞性肺气肿疗效的影响。方法　建立新西兰大白兔阻塞性肺气肿模型 ,将 5 0只肺气肿兔随机分为肺气肿组 (A组 )、小量LVRS组 (B组 )、中量LVRS组 (C组)、大量LVRS组(D组 )和假手术组(E组 ) 5组 ,每组各 10只 ,8周后进行肺功能和肺组织学检查。结果　与A组比较 ,C组的潮气量、0 3s用力呼气容积 (FEV0 3 )、FEV0 3 /FVC(用力肺活量)、PaO2 、平均肺泡数和肺泡隔面密度增加 ,功能残气量、PaCO2 、肺总容积和肺泡直径降低 (P <0 0 5 ) ,而B、D、E组无明显变化 (P >0 0 5 )。组织学检查C组气道炎症减轻 ,肺气肿明显改善。结论　单侧适量LVRS可有效改善兔阻塞性肺气肿。

Therapeutic effect of single-sided lung volume reduction surgery with different resection volumes on obstructive emphysema in rabbit

Objective To evaluate the therapeutic effect of single-sided lung volume reduction surgery (LVRS) with different resection volumes on obstructive emphysema in rabbit. Methods Obstructive emphysema was reproduced in 50 New Zealand white rabbits with smog and elastase, and they were randomly divided in equal number into emphysema (A), small volume LVRS (B), moderate volume LVRS (C), large volume LVRS (D), and shame operation (E) groups. LVRS with different resection volumes was carried out groups B, C, and D. Pulmonary functions, artery blood gas analysis and pulmonary histology were determined 8 weeks later. Results Compared with those in group A, vital volume (V T), 0.3 second forced expiratory volume (FEV 0.3), FEV 0.3/FVC (forced expiratory capacity), PaO 2, density of alveolar septum (Ds) and number of alveolus (Na) were increased postoperatively, and PaCO 2, total lung capacity (TLC), functional residual capacity (FRC) and diameter of alveolus (Da) were decreased in group C (P<0.05), but no obvious changes were found in B, D and E groups (P>0.01). Morphological improvements of emphysema were noticed under naked eye and optical microscope only in C group. Conclusion Single-sided LVRS with appropriate resection volume can improve effectively obstructive pulmonary emphysema in rabbit.