经纤维支气管镜生物性肺减容术的动物实验

目的:探讨生物性肺减容术糜蛋白酶代替胰蛋白酶的合适剂量、国产生物蛋白胶中纤维蛋白原与凝血酶的最佳配比、706代血浆替换小牛血清的可行性.方法:9头健康约克幼猪(体重16～22 kg)分别标记1～9号.第一阶段用不同剂量(A,B两种)糜蛋白酶和不同配比(A',B'两种)生物蛋白胶配伍加上小牛血清通过纤维支气管镜给药于1～...

BIOLOGICAL LUNG VOLUME REDUCTION IN ANIMAL BY BRONCHOFIBROSCOPE

Objective：To study the optimal dose of chymotrypsin replacement to trypsin,the best match between fibrin and thrombin in fibrin hydrogel,and the possibility of 706 reagent replacement to fetal bovine serum in biological lung volume reduction（BLVR）.Methods：Nine young pigs（16~22 kg） were individually marked by NO.1 to NO.9.In the first step：BLVR was performed for four pigs（NO.1 to NO.4）with different dose of chymotrypsin and fibrin hydrogel.All animals were done by chest helical computed tomography scanning before BLVR and at 1 week,1 month,3 months after BLVR,then the pigs were killed and their whole lungs were harvesred,photographed and examined histologically at 3 months later.Then the four reagents projects were evaluated and selected the best one to perform the BLVR in the second step＇,in which the fetal bovine serum was replaced with the 706 reagent.Results：① Chest CT volume evaluation showed that the volume of right lung/total lung in Pig 1（before BLVR 51%→3 month later 56.8%） and Pig 2（44.4%→55.2%） was not to decreased,but in Pig 3（57.6%→45.7%）,Pig 4（56.8%→51.6%）,so on was significantly decreased.The target subsegment of the lungs of Pig 1 and Pig 2 looked as the same as the other lung,they were touched softly and didn＇t adhere to the adjacent chest wall.The target subsegment of the lung of Pig 3 looked phoeniceous and adhered to the adjacent chest wall badly,and a smooth lump,the size of which was 3.5 cm×3.5 cm,was found on the diaphragmatic surface adjacent to the target lung segment.Microscopic observation included target segment fibrosis,necrotic tissue and lung abscess formation.The target subsegment of the lung of Pig 4 looked grey,solider,smaller and adhered to the adjacent chest wall slightly.Microscopic observation of it included fibrosis,atelectasis and inflammatory cell infiltration.②It also showed that 706 reagent could replaced with fetal bovine serum and resulted in significant lung volume reduction in the target segment.Conclusion：In the BLVR,the trypsin can be replaced with the chymotrypsin,and the fetal bovine serum can be replaced with the 706 reagent.In addition,the BLVR with chymotrypsin B,706 reagent and fibrin hydrogel B＇ appears safe and effective without severe complications.