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目的:术中定位是微小肺癌手术面临的主要难题,而原因则是肺在术中萎陷造成的巨大形变。我们从研究肺的术中萎陷着手,建立肺渐次萎陷动物模型,模拟肺在术中发生的萎陷,用以研究肺萎陷的过程、规律及影响因素,为微小肺癌的术中定位提供理论基础。本文用渐进的人工气胸模拟肺在术中的渐次萎陷过程,探讨简便、有效的肺渐次萎陷动物模型的制作方法。方法:健康成年犬12只机等分入左、右侧手术组麻醉后移至CT扫描床采用切小口置管和胸腔穿刺两种方式制作人工气胸。向胸膜腔内分次、定量地注射气体,使肺逐渐萎陷直至完全萎陷。通过夹闭气管插管协助稳定肺的萎陷状态。将各萎陷状态分别进行CT扫描。结果:所有实验犬均顺利完成实验麻醉良好,无意外情况发生。9只犬给予气管插管,3只未给予气管插管;4只犬采用切小口置管方式制作气胸,8只采用胸腔穿刺方式。气管插管增加了模型制作难度,但有利于稳定肺的萎陷状态;胸腔穿刺方式相对操作更为简便。随着向胸膜腔内注射气体,肺缓慢而均匀地向肺门方向集中,萎陷进程满意。CT扫描记录了肺从膨胀到萎陷的各阶段,经过后期重建再现了肺的萎陷过程。5只犬出现并发症,均通过改变操作得以纠正,未影响实验进程。结论:本研究建立的肺渐次萎陷动物模型,能够很好地模拟肺在术中的萎陷过程,是研究术中肺萎陷的理想动物模型。
OBJECTIVES: Intraoperative positioning is the major challenge faced by minimally invasive lung cancer surgery. The reason for this is the huge deformation caused by collapse of the lung during surgery. We collapsed from the study of lung surgery to establish animal model of progressive lung collapse, simulating the collapse of the lung during surgery to study the process of lung collapse, regularity and influencing factors for the positioning of microscopic lung cancer Provide a theoretical basis. In this paper, with gradual artificial pneumothorax to simulate the process of lung collapse in the process of collapse, to explore the simple and effective animal model of progressive lung collapse of the production method. Methods: 12 healthy adult dogs were divided equally into the left and right operation groups and then moved to the CT scan bed under anesthesia. The artificial pneumothorax was made by incision of small mouth and thoracentesis. To the pleural cavity sub-graded, quantitative injection of gas, the lung gradually decay until complete collapse. Closure of tracheal intubation to help stabilize the collapsed state of the lungs. Each state of collapse CT scan. Results: All experimental dogs successfully completed the experiment anesthesia well, no accident occurred. Nine dogs were given endotracheal intubation and three were not given endotracheal intubation. Four dogs were treated by incision sutured to produce pneumothorax and eight were treated by thoracentesis. Endotracheal intubation increases the difficulty of making the model, but it helps to stabilize the collapse state of the lung; the thoracentesis is relatively easy to operate. With the injection of gas into the pleural cavity, the lung slowly and uniformly concentrated to the hilar direction, the process of collapse was satisfactory. The CT scan records the various phases of the lung from swelling to collapse, and reconstructs the process of lung collapse after the reconstruction. Five dogs with complications were corrected by changing the operation without affecting the course of the experiment. CONCLUSION: The animal model of gradual lung collapse established in this study can well simulate the process of lung collapse during surgery, and is an ideal animal model for the study of pulmonary collapse.