化学胶和纤维蛋白胶栓塞兔肺支气管的初步对照研究

目的 研究α-氰基丙烯酸烷基酯类化学胶(化学胶)和纤维蛋白胶栓塞支气管的效果差异以及胰蛋白酶在其中的辅助作用.方法 30只新西兰兔完全随机分为化学胶组、纤维蛋白胶组、胰蛋白酶+化学胶组、胰蛋白酶+纤维蛋白胶组和单纯胰蛋白酶组.化学胶组、纤维蛋白胶组分别使用相应粘接剂栓塞兔肺支气管；胰蛋白酶+化学胶组、胰蛋白酶+纤维蛋白胶组先用猪胰蛋白酶预处理支气管,然后分别采用相应粘接剂栓塞兔肺支气管；单纯胰蛋白酶组只用猪胰蛋白酶处理支气管而不进行支气管栓塞.栓塞操作在X线透视下进行,通过CT扫描观察兔肺不张的发生发展.2周后处死动物,取出兔肺标本进行病理研究.结果 化学胶组全部动物出现肺不张且持续到2周.纤维蛋白胶组栓塞后第2天4只动物出现短期的肺不张,10 d时已经全部复通.联合使用胰蛋白酶组肺组织病理有纤维组织增生.结论 化学胶栓塞支气管效果优于纤维蛋白胶效果.栓塞前用胰蛋白酶预处理支气管能够使肺不张更加稳定,具有很好的协同作用.

Preliminary study of embolizing bronchia with fibrin glue and chemical rubber

Objective To study the different effects of bronchial embolization between the fibrin glue and the chemical rubber and the additional role of the trypsin in bronchial embolization. Methods All 30 animals were randomly divided into five groups, including chemical rubber group, fibrin group, trypsin ＋ chemical rubber group, trypsin ＋ fibrin group and trypsin group （n = 6 in each group）. Embolizing bronchia with chemical rubber and fibrin glue was conducted respectively in chemical rubber group and fibrin group. Pretreating bronchiole with trypsin was done at first, and then the bronchiole was embolized in trypsin ＋ chemical rubber group and trypsin ＋ fibrin group. The embolism was done under the X-ray, then CT scan was used to detected the development of the pulmonary atelectasis. Two weeks after the embolism the animals were killed for lung pathology. Results All of the animals with the chemical rubber had the atelectasis. Only 4 cases of the animals with the fibrin glue appeared short-term atelectasis and all of them recovered in 10 days. The fibrous tissue proliferation could be seen in animals with the trypsin. Conclusions The effect of embolizing bronchia with the fibrin glue is not good enough. The chemical rubber of a- cyanoacrylate alkyl is more preferable. At same time pretreating bronchiole with trypsin can enhance the embolism and get stable atelectasis.