| Emphysema is a debilitating lung disease continuing to be a major part of Chronic Obstructive Pulmonary Disease. Emphysema is characterized by permanent and anatomically irreversible enlargement of air spaces distal to the terminal bronchiole,accompanied by destruction of their walls, it makes the lung tissues over expanded and therefor the lung function descents. Bronchoscopic Lung Volume Reduction(BLVR), which is basing on the principle of Lung Volume Reduction Surgery, means fixing the one-way gas flap or packing the bronchus by drugs under the visual field of the bronchoscope, in order to make the over expanded emphysima tissue collapse.This experiment is designed to show that after BLVR , the animals, the incidence of postoperative complications, the safety of BLVR,and that comparative observation of postoperative postoperative atelectasis of the situation, the treatment of BLVR effect.From February 1, 2010 to May 10, 2010 ,we use health, male, general hybrid minipigs 8, weight 15-24Kg, aged 3.5-4.5 months, by the Experimental Animal Center of Jilin University,to produced lung swelling model, and then place the one-way valve device by fiberoptic bronchoscopy through the preoperative, postoperative lung CT imaging in pulmonary pathological changes observed compared before and after valve implantation effect.The results show that the eight animals successfully established experimental animal model of emphysema, a total of 10 pieces into one-way valve device, of which one is not strong because of the fixed by endotracheal intubation to cough up after implantation, and the remaining 9 were placed successfully . Into one-way valve in the device 2 months after the animals cough, runny nose, shortness of breath and other symptoms after the event marked improvement, no lack of energy, no diet and weight loss. 8 cases general observation of the lung pathology: Experimental animal placed distal lung tissue valve can be seen the appearance of lung tissue reduced the volume limitations, the color is dark brown. Non-smooth surface treatment of the regional lung volume increases, the pale color, the surface of a large bubble formation, and decreased elastic recoil force, means the pressure after the left-prints, cut more than has been seen more integration of the alveolar cavity. HE staining and pathological examination under light microscope, light microscope, place the valve distal alveolar collapse in lung tissue, was the formation of boundaries with the surrounding tissue. The lungs of non-treatment area distal terminal bronchioles were significantly expand the air space, alveolar wall meager and multiple fracture, the adjacent alveolar merging into larger alveoli, elastic fiber damage. Animal models in the production of 8 cases before the animals were anesthetized, the lung CT examination: heart, lungs and mediastinum without organic lesion. 5 times a week in captivity into the elastase and lung CT examination after anesthesia: 8 cases of animals were different degrees of emphysema on the performance, and 5 shows left lower lobe bulla, 3 cases of other lung swollen like changes, such as: reduced lung markings, increased by degrees. Months after the one-way valve device into the lung CT imaging studies, showing that the left lung volume reduction, restoration of normal lung markings.This study used fiberoptic bronchoscopy to the target protein into the lung, successfully created a model of heterogeneous emphysema. Experimental miniature pig fiberoptic bronchoscope into one-way valve device, cough, shortness of breath symptoms relieved, the target lung tissue, cough, shortness of breath symptoms relieved, the target lung tissue, pulmonary collapse, rather than the treatment area does not appear atelectasis, image analysis further revealed that the volume reduction of lung alveolar collapse, and the surrounding tissue boundaries clear, and lung CT imaging studies, showing that the target lung volume reduction, restoration of normal lung markings, indicating the one-way valve device bronchoscopy lung volume reduction surgery is effective, has good application prospects. Animals recovered well and were not there during and after hypoxemia, hemoptysis, severe dyspnea, which is the treatment of emphysema heterogeneity of clinical indications and the relaxation can play a selection of reference, but this Department of animal experiments, and the sample size, subjective feelings can not be observed, the need to further validate its clinical effects. |
