功能性肺叶切除可行性和安全性的实验研究

目的探讨功能性肺叶切除术(FPLT)的可行性和安全性。方法16条杂种犬随机分为实验组和对照组各8条。实验组行FPLT术，先于靶肺叶灌注博莱霉素-碘化油乳剂，然后阻塞靶气管；对照组行靶肺叶切除。观察两组术前、术后1小时及第7、14、21、28天肺部X线表现和血气变化。结果术后1小时两组血氧饱和度均下降，术后第7天动脉氧分压均恢复正常，但实验组下降显著，肺内分流明显增加；靶肺逐渐萎陷，第28天多数靶肺形成肺不张、肺纤维化。结论FPLT后靶肺可形成肺不张、肺纤维化其血气变化与肺叶切除术者相似，效果优于传统的肺叶切除术。

Study of the feasibility and security of funcitional pulmonary lobectomy

Objective To study the feasibility and security of functional pulmonary lobectomy(FPLT). Methods 16 mongrel healthy dogs were divided into experimental group(n=8) and control group (n=8) randomly. The target lung lobes in experimental group were filled with emulsion of bleomycin and lipiodol and the target bronchi were occluded. The target lung lobes in control group were resected. The chest X-ray findings and blood gas were observed pre-procedure and post-procedure (1h and 7,14.21.28days respectively). Results The arterial oxygen pressure decreased in both groups,especially in experimental group,and then returned to normal level at about 7 days later. Intrapulmonary shunt increased in experimental group 1h after procedure and the atelectasis radiologically and fibrosis histologically of target lung lobes were observed on 28th day. Conclusion FPLT may induce the atelectasis and fibrosis of the target lung lobe, and its effect is superior to surgical pulmonary lobectomy,while the change of blood gas in both groups are similar.