功能性肺叶切除动物模型肺小动脉变化的观察

目的 探讨应用平阳霉素-碘化油乳剂（PLE）实现功能性肺叶切除（FPLT） 的可行性及肺小动脉的病理变化,评价其对肺循环的影响. 材料与方法健康犬16只,随机分成两组,A组12只,B组4只.A组行靶肺支气管肺泡灌注PLE并用支气管封堵器堵塞靶肺支气管,B组为对照组.A组分别于术后28天、56天各处死6只取肺组织,B组各处死2只,测定肺纤维化的程度,运用图像分析仪测量肺小动脉中膜厚度占血管外径比值（mMTPA）和相对中膜面积（WA/TA）. 结果 FPLT术后A组动物组织病理学显示靶肺呈纤维化改变,肺小动脉管壁增厚,管腔部分闭塞;非靶肺未见明显纤维化,未出现血管重构现象. 结论 向靶肺支气管肺泡灌注PLE并用支气管封堵器堵塞靶支气管可达到功能性肺叶切除的目的 ,该方法安全、简便,术后对肺循环无明显不良影响.

Pathological Observating of Pulmonary Arterioles after Functional Pulmonary Lobectomy in Dogs

Objective To investigate the feasibility and pathological findings in pulmonary arteries after functional pulmonary lobectomy(FPLT), and to evaluate its influence on the pulmonary circulation after FPLT. Materials and Methods 16 healthy dogs were randomly divided into two groups: Group A (n=12) and Group B (n=4). Pingyangmycin lipiodol emulsion(PLE) was injected to the target lung, and the target bronchia was obstructed with broncho occluder by catheter. Group B were control group. Six dogs of group A and two dogs of group B were sacrificed on 28th and 56th day respectively, and the lungs were harvested for pathological examination. The degree of pulmonary fibrosis was measured. The measurements of mean medial thickness in pulmonary arteries (mMTPA) and ratio of vessel wall area to vessel total area (WA/TA ) were accomplished by the microscopic image analysis program. Results Different degree fibrosis in target lung was histopathologically depicted in group A, the thickness of middle and small pulmonary arterial wall increased and the cavity became narrow, no fibrosis and no vascular remodeling in nontarget lung in group B. Conclusion FPLT can be obtained after PLE was injected to the target lung and the target bronchia was obstructed with broncho occluder by catheter. FPLT is a safe and effective method, which has no influence to the pulmonary circulation after FPLT.