肺部感染对支气管封堵治疗影响的实验研究

目的:探讨肺部感染对支气管封堵治疗影响的动物实验性研究。方法:取健康杂种犬18条,分为3组(A、B、C组)(n=6),经支气管镜每只犬置入致密螺栓状支气管封堵器2枚,其中A、B组为肺部感染组,C组仅为单纯封堵(A、C组封堵后使用抗生素,而B组封堵后未使用抗生素)。观察实验动物的耐受性,定期复查血象、支气管镜、胸部CT扫描,8周后观察封堵器附近支气管组织及远端肺组织变化。结果:观察期内,除1例因给药管不慎封堵入靶支气管内而死亡外,其余犬耐受性良好;截至封堵第8周,36只封堵器中,脱落共有0只(0/36)。胸部CT扫描和组织病理学检查证实,部分封堵的肺叶有萎陷,封堵部位远端肺泡腔缩小,5例封堵部位及其周围有轻度阻塞性炎症改变,未出现肺脓肿及坏死。肺部感染因素对犬的恢复有延迟;而感染组术后肌注抗生素与否,并未能缩短实验动物的不适反应过程,亦未能预防或减少阻塞性炎症的发生。结论:试制的支气管封堵器置入方便,组织相容性好;无论单纯封堵还是肺部感染组的封堵,各组实验动物均有较好的耐受性,但是肺部感染因素对犬的恢复有延迟;肺部感染组术后肌注抗生素与否,对提高动物的耐受程度无明显作用。

Study in effect of bronchial occlusive treatment in dogs of pulmonary infection

Objective:To assess the safety of bronchial occlusive treatment in dogs of pulmonary infection.Methods:EightIIN healthy mongrel dogs were divided into 3 groups(n=6,each group).Every dog was inserted with two compact screw-like bronchial oc- clusive devices.Group A and B were the groups of lung infection;and group C was merely simple occlued(Groups A and C used antibi- otics after occlusion;but groups B not used).The tolerance of dogs were observed,and the hemogram,bronchoscopy and computer to- mography scan of chest were performed regularly.After 8 weeks,the changes of bronchial and lung tissue adjacent to occlusive devices were observed.Results:During the observation,except for one dog died because of occluding incautiously the tube of injecting drugs into the target bronchus,the others were well-tolerable.By the end of 8 weeks after operation,all bronchial occlusive devices had no shedding (0/36).The computer tomography scan and histopathologic examination showed that some of the lung tissue had collapsed,pulmonary alveolus distal to occlusive device collapsed obviously.Obstructive pneumonia happened in five cases,but no lung abscess and tissue necrosis.The factor of pulmonary infection delayed the restoration of dogs;and whether using the intramuscular injection of antibiotics after occlusion or not could not shorten the process of discomfort response,and failed to prevent or reduce the incidence of obstructive pneumonia.Conclusion:The compact screw-like bronchial occlusive device can be implanted into the target bronchi by bronchoscope conveniently,with good tissue compatibility.Whether the groups of simple insertion or pulmonary infection,all of groups were well-tol- erable,but the factor of pulmonary infection would delayed the restoration of dogs;and whether using the intramuscular injection of an- tibiotics after inserting or not could not enhance the tolerance of laboratory animals.