阻塞性肺不張動物模型建立及MSCT與病理學(xué)對比研究
發(fā)布時間：2018-09-14 14:12
【摘要】：第一部分螺旋CT對日本大耳白兔氣道的測量研究 目的:探討日本大耳白兔氣管和主支氣管各種解剖徑線的長度、角度及相關(guān)性,為進行氣道疾病內(nèi)支架介入治療的動物實驗研究奠定基礎(chǔ)。 方法:多層螺旋CT掃描30例成年健康日本大耳白兔的頸胸部,測量氣管各段前后徑、左右徑,使用MSCT技術(shù)將氣管拉直,測算聲門水平到隆突的氣管長度,左右主支氣管和中間支氣管內(nèi)徑與長度,以及左、右主支氣管長軸與矢狀面的夾角。 結(jié)果:氣管各段直徑、左右肺尖葉支氣管開口內(nèi)徑無差異,右主支氣管內(nèi)徑大于左側(cè),而右主支氣管長軸與矢狀面夾角、長度則小于左側(cè),并有相關(guān)性。 結(jié)論:多層螺旋CT測定的日本大耳白兔氣管、左和右主支氣管徑線值,獲得左、右主支氣管內(nèi)徑值、長度、嵴下角之間的回歸方程,有助于為兔實驗提供相關(guān)氣管和支氣管的解剖參數(shù)。 第二部分阻塞性肺不張動物模型的建立 目的:探討日本大耳白兔氣道內(nèi)支架置入技術(shù)的方法,評價氣管支氣管一體化覆膜內(nèi)支架封堵法建立阻塞性肺不張的動物模型的可行性,旨在建立一種新的比較接近生理狀態(tài)的阻塞性肺不張動物模型。 方法:健康成年日本大耳白兔42只,雌雄不限,體重1.64～3.75kg,平均為2.50kg。隨機分成7組,即2d、4d、1w、2w、1m、2m、3m組,每組6只。在DSA引導(dǎo)下使用淺麻醉方法,在42只兔氣道內(nèi)置入氣管支氣管一體化覆膜內(nèi)支架。術(shù)前和在規(guī)定時間內(nèi)分別測量體溫、體重、白細胞計數(shù)、MSCT等,判斷是否形成阻塞性肺不張。 結(jié)果:置入42個兔氣道內(nèi)支架,其中成功35例、支架位置不佳3例、術(shù)中死亡4例,置入成功率為83%,術(shù)后死亡3例,未形成肺不張2例,肺不張成功率74%。 結(jié)論:DSA引導(dǎo)下使用淺麻醉方法,置入氣管支氣管一體化覆膜內(nèi)支架的方法制作阻塞性肺不張動物模型,方法簡單,操作容易,內(nèi)支架置入成功率和肺不張形成率均較高。 第三部分阻塞性肺不張動物模型的MSCT和病理學(xué)對比研究 目的:目前氣管內(nèi)支架置入術(shù)已成為治療阻塞性肺不張一個行之有效的且微創(chuàng)的方法,但是確定治療阻塞性肺不張的最佳時機還沒有統(tǒng)一,該實驗探討肺不張動物模型的MSCT和組織學(xué)的相關(guān)性,有助于診斷和治療阻塞性肺不張。 方法:選取48只成年健康日本大耳白兔,隨機分成8組,每組6只,包括對照組1組,實驗組7組。實驗組中每只兔子放置氣管支氣管支架制作肺不張模型,在規(guī)定的時間內(nèi)測量MSCT值并處死,取不張肺組織并切片,光鏡下觀察不同組不張肺的病理變化,分析兩者相關(guān)性。 結(jié)果:不張肺的CT密度隨著時間的延長而增加,MSCT影像征像和病理變化的相關(guān)性如下:前期4d內(nèi)肺泡塌陷,肺泡間質(zhì)毛細血管擴張有充血,肺不張的密度低,7d～1m期間由于肺組織出現(xiàn)炎性滲出,肺泡內(nèi)有大量的炎性細胞,此期是阻塞性肺炎發(fā)生時期,密度值一般在30-40Hu之間,1月后肺組織炎癥逐漸減輕,炎癥細胞主要集中在細支氣管周圍,壁內(nèi)炎細胞浸潤。2月后細支氣管粘膜層和平滑肌逐有破壞,3月肺組織內(nèi)出現(xiàn)大量細支氣管擴張,周圍平滑肌缺少,內(nèi)部充滿大量的炎癥細胞,肺泡上皮增生變厚。此期的MSCT密度在40Hu之上。增強顯示不張肺強化不是十分均勻,7d和14d強化比較明顯。 結(jié)論:阻塞性肺不張最佳治療時機是支氣管未破壞和形成支擴之前,CT值應(yīng)是40Hu以下。阻塞性肺不張晚期最終進展為細支氣管和支氣管擴張。
[Abstract]:Part one measurement of airway in Japanese white rabbits by spiral CT
Objective: To investigate the length, angle and correlation of various anatomical diameters of trachea and main bronchus in Japanese big-eared rabbits, and to lay a foundation for the animal experimental study of stent interventional therapy for airway diseases.
Methods: 30 healthy adult Japanese rabbits were scanned by multi-slice spiral CT. The anterior and posterior diameters, left and right diameters of trachea were measured. The trachea was straightened by MSCT. The length of trachea from glottis level to carina, the inner diameter and length of left and right main bronchi and middle bronchi, and the angle between the long axis of left and right main bronchi and sagittal plane were measured.
Results: There was no difference in the diameter of each segment of the trachea and the inner diameter of the left and right pulmonary apical lobes. The inner diameter of the right main bronchus was larger than that of the left, while the length of the long axis of the right main bronchus was less than that of the left.
Conclusion: The regression equations between the diameters, lengths and angles of the left and right main bronchus can be obtained by measuring the diameters of the trachea, left and right main bronchus with multi-slice spiral CT, which is helpful to provide anatomical parameters of the trachea and bronchus in rabbits.
The second part is the establishment of animal models of obstructive atelectasis.
Objective: To explore the method of stent placement in the airway of Japanese big-eared rabbits and to evaluate the feasibility of establishing an animal model of obstructive atelectasis with tracheobronchial integrative covered stent occlusion.
Methods: Forty-two healthy adult Japanese white rabbits, male and female, weighing 1.64-3.75 kg, with an average of 2.50 kg, were randomly divided into 7 groups, namely, 2 days, 4 days, 1 w, 2 w, 1 m, 2 m, 3 m groups, with 6 rabbits in each group. Weight, white blood cell count, MSCT, etc., to determine whether the formation of obstructive atelectasis.
Results: 42 rabbit airway stents were implanted, of which 35 were successful, 3 were in poor stent position, 4 died during operation, the success rate was 83%, 3 died after operation, 2 did not form atelectasis, and the success rate of atelectasis was 74%.
Conclusion: The animal model of obstructive atelectasis was established by DSA-guided shallow anesthesia with tracheobronchial integrated covered stent implantation. The method is simple and easy to operate. The success rate of stent implantation and atelectasis formation rate are high.
The third part is a comparative study of MSCT and pathology in obstructive atelectasis animal models.
Objective: At present, endotracheal stenting has become an effective and minimally invasive method for the treatment of obstructive atelectasis, but the best time to determine the treatment of obstructive atelectasis has not been unified. This experiment explores the correlation between MSCT and histology in animal models of atelectasis, which is helpful for the diagnosis and treatment of obstructive atelectasis.
Methods: Forty-eight healthy adult Japanese white rabbits were randomly divided into 8 groups, 6 rabbits in each group, including control group 1 and experimental group 7. Each rabbit in the experimental group was placed with tracheobronchial stent to make atelectasis model. The MSCT values were measured and executed in the prescribed time. The atelectasis tissues were taken and sliced. The pathological changes of atelectasis in different groups were observed under light microscope. Change and analyze the correlation between them.
Results: The CT density of atelectasis increased with time. The correlation between MSCT imaging and pathological changes was as follows: alveolar collapse, alveolar interstitial capillary dilatation congestion, atelectasis density was low in the early 4 days. Inflammatory exudation occurred in the lung tissue during 7 days to 1 m, and a large number of inflammatory cells were found in the alveoli, which was obstructive pneumonia. During the occurrence period, the density value is generally between 30 and 40 Hu. After 1 month, the inflammation of lung tissue gradually alleviates. Inflammatory cells mainly concentrate around bronchioles and infiltrate intramural inflammatory cells. Cells and alveolar epithelial hyperplasia thickened. At this stage, MSCT density was above 40 Hu. Enhancement showed that atelectasis enhancement was not very uniform, and enhanced significantly at 7 and 14 days.
CONCLUSION: The best time to treat obstructive atelectasis is before bronchiectasis and bronchiectasis, and the CT value should be below 40 Hu.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2009
【分類號】：R563.4;R-332
[Abstract]:Part one measurement of airway in Japanese white rabbits by spiral CT
Objective: To investigate the length, angle and correlation of various anatomical diameters of trachea and main bronchus in Japanese big-eared rabbits, and to lay a foundation for the animal experimental study of stent interventional therapy for airway diseases.
Methods: 30 healthy adult Japanese rabbits were scanned by multi-slice spiral CT. The anterior and posterior diameters, left and right diameters of trachea were measured. The trachea was straightened by MSCT. The length of trachea from glottis level to carina, the inner diameter and length of left and right main bronchi and middle bronchi, and the angle between the long axis of left and right main bronchi and sagittal plane were measured.
Results: There was no difference in the diameter of each segment of the trachea and the inner diameter of the left and right pulmonary apical lobes. The inner diameter of the right main bronchus was larger than that of the left, while the length of the long axis of the right main bronchus was less than that of the left.
Conclusion: The regression equations between the diameters, lengths and angles of the left and right main bronchus can be obtained by measuring the diameters of the trachea, left and right main bronchus with multi-slice spiral CT, which is helpful to provide anatomical parameters of the trachea and bronchus in rabbits.
The second part is the establishment of animal models of obstructive atelectasis.
Objective: To explore the method of stent placement in the airway of Japanese big-eared rabbits and to evaluate the feasibility of establishing an animal model of obstructive atelectasis with tracheobronchial integrative covered stent occlusion.
Methods: Forty-two healthy adult Japanese white rabbits, male and female, weighing 1.64-3.75 kg, with an average of 2.50 kg, were randomly divided into 7 groups, namely, 2 days, 4 days, 1 w, 2 w, 1 m, 2 m, 3 m groups, with 6 rabbits in each group. Weight, white blood cell count, MSCT, etc., to determine whether the formation of obstructive atelectasis.
Results: 42 rabbit airway stents were implanted, of which 35 were successful, 3 were in poor stent position, 4 died during operation, the success rate was 83%, 3 died after operation, 2 did not form atelectasis, and the success rate of atelectasis was 74%.
Conclusion: The animal model of obstructive atelectasis was established by DSA-guided shallow anesthesia with tracheobronchial integrated covered stent implantation. The method is simple and easy to operate. The success rate of stent implantation and atelectasis formation rate are high.
The third part is a comparative study of MSCT and pathology in obstructive atelectasis animal models.
Objective: At present, endotracheal stenting has become an effective and minimally invasive method for the treatment of obstructive atelectasis, but the best time to determine the treatment of obstructive atelectasis has not been unified. This experiment explores the correlation between MSCT and histology in animal models of atelectasis, which is helpful for the diagnosis and treatment of obstructive atelectasis.
Methods: Forty-eight healthy adult Japanese white rabbits were randomly divided into 8 groups, 6 rabbits in each group, including control group 1 and experimental group 7. Each rabbit in the experimental group was placed with tracheobronchial stent to make atelectasis model. The MSCT values were measured and executed in the prescribed time. The atelectasis tissues were taken and sliced. The pathological changes of atelectasis in different groups were observed under light microscope. Change and analyze the correlation between them.
Results: The CT density of atelectasis increased with time. The correlation between MSCT imaging and pathological changes was as follows: alveolar collapse, alveolar interstitial capillary dilatation congestion, atelectasis density was low in the early 4 days. Inflammatory exudation occurred in the lung tissue during 7 days to 1 m, and a large number of inflammatory cells were found in the alveoli, which was obstructive pneumonia. During the occurrence period, the density value is generally between 30 and 40 Hu. After 1 month, the inflammation of lung tissue gradually alleviates. Inflammatory cells mainly concentrate around bronchioles and infiltrate intramural inflammatory cells. Cells and alveolar epithelial hyperplasia thickened. At this stage, MSCT density was above 40 Hu. Enhancement showed that atelectasis enhancement was not very uniform, and enhanced significantly at 7 and 14 days.
CONCLUSION: The best time to treat obstructive atelectasis is before bronchiectasis and bronchiectasis, and the CT value should be below 40 Hu.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2009
【分類號】：R563.4;R-332
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