肺邻近器官及支气管残端的冷冻效应与并发症

目的 为探讨晚期肺癌侵及邻近器官及支气管残端的癌残留能否行致死性冷冻、被冷冻器官会产生何种生物效应及并发症。方法 成年家犬30只，18只犬肺切除后支气管残端采用液氮行冷冻处理，12只犬冷冻肺邻近器官(其中食管4例，膈肌3例，胃3例，肝脏2例)，现察10h一7个月(平均4．5个月)。结果 见冷冻的支气管残端均有坏死，随观察时间的延长逐渐形成纤维瘢痕。全组均束发生残端破裂或支气胸膜瘘。冷冻食管4例，3例冷冻区食管狭窄，狭窄段为较薄的纤维膜状瘢痕。冷冻胃3例，见胃内壁形成瘢痕溃疡(食管、胃穿孔各1例)。冷冻膈肌3例，未见膈肌破裂。冷冻肝脏2例，见形成黄色瘢痕。结论 冷冻坏死发生缓慢，纤维组织对冷冻的耐受性较强，使坏死组织不致很快脱落；原有的组织细胞结构坏死消失，纤维结缔组织明显增生，各冷冻区坏死组织边缘新生毛细血管多。

The effect and complications of cryosurgery on adjacent organs of lung and residual bronchia

Objective To assess the biochemical effective and complications of the tissue by cryosurgery after the treatment of late stage lung cancer and residual tissue following lobectomy.Methods Thirty dogs were divided into two groups.Eighteen dogs had operation of lobectomy,the proximal bronchia had been treated by cryosurgery.The adjacent tissues(4 cases of esophagus,3 cases of diaphragm,3cases of stomach,2 cases of liver)of another 12 dog had been treated by cryosurgery too.The survey had been achieved during 10hours to 7 months respectively after operation(average was 4.5 months).Results All the cases have cryonecrosis in the site of residual bronchia after treatment of cryosurgery.The fibrosis was found gradually with the time after operation.No fistula was found in the bronchia and pleura.Three of 4 esophagus cases were found the stenosis,In these site there are membrane of fibrosis also.3 stomach cases ulcerated(One case of esophagus and one case of stomach were found perforation).Three cases of diaphragm were not found the perforation.Two cases of liver being treated by cryosurgery,there yellow scar were found.Conclusion The cryonecrosis formed very slowly.Fibrotic tissue is tolerant to the cryosurgery,it result in that the tissue of cryonecrosis could not come off easily.The original construction disappeared,the fibrosis is significant.In the place of cryonecrosis,there were many capillary proliferated are found.