传统肺减容术和肺叶切除后兔肺功能及组织结构的比较

目的对比传统肺减容术(LVRS)和肺叶切除术后阻塞性肺气肿兔的肺功能和组织结构变化.方法40只肺气肿兔随机等分为4组肺气肿组(A组)、传统LVRS组(B组)、肺叶切除组(C组)和假手术组(D组),8周后进行肺功能和肺组织学检查.结果与A组比较,B组和C组的潮气量、0.3 s用力呼气容积(FEV0.3),FEV0.3/FVC(用力肺活量)、PaO2、平均肺泡数和肺泡隔面密度增加,功能残气量、paCO2、肺总容积和肺泡直径降低(P＜0.05),而D组变化不明显(P＞0.05).B组和C组肉眼及光镜下可见肺气肿改善,而D组无明显变化.B组和C组之间上述各指标无显著差异(P＞0.05).结论传统的LVRS和肺叶切除术均可有效改善阻塞性肺气肿兔的肺功能和组织结构.

Comparison of rabbits' pulmonary function and histology after conventional lung volume reduction surgery with those after lobectomy

To compare rabbits' pulmonary function and histology after conventional lung volume reduction surgery (LVRS) with those after lobectomy. Obstructive emphysema was induced in 40 New Zealand white rabbits with smog and elastase, which were randomly and equally divided into four groups, i.e., control group (Group A), conventional LVRS group (Group B), lobectomy group (Group C) and sham operation group (Group D). Conventional LVRS, lobectomy and thoracotomy without pulmonary resection were performed in group B, C and D respectively. Eight weeks later, pulmonary functions, artery blood gas analysis and pulmonary histology were observed. Compared with Group A, vital volume (VT), forced expiratory volume within 0.3 second (FEV0.3),FEV0.3/FVC (forced vital capacity), PaO2,density of alveolar septum (Ds) and number of alveolus (Na) increased postoperatively, but PaCO2,total lung capacity(TLC), functional residual capacity (FRC) and diameter of alveolus (Da) decreased in Groups B and C (P <0.05). There was no obvious change in Group D (P >0.05). Meanwhile, there was no difference between Group B and Group C (P >0.05). Morphological changes of obstructive emphysema were noticed under naked eyes and optical microscope in Group B and C, while no above changes were observed in Group D. Conclusions] Both conventional single lateral LVRS and lobectomy can effectively improve the pulmonary function and histology of emphysematous rabbits.