Effects of intrabronchial foreign body retention
Effects of intrabronchial foreign body retention
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DOI：
10.1002/ppul.10021
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发表时间：
2002-05-01
影响因子：
3.1
通讯作者：
Küllü, S
中科院分区：
文献类型：
--
作者：
Yildizeli, B;Zonüzi, F;Küllü, S
不明原因的支气管异物(FBS)会导致呼吸道发生不可逆转的变化。然而，这些变化的确切过程并不为人所知。我们建立了一种支气管梗阻的动物模型，以放射学和组织病理学的方法评估梗阻后肺变化的发展。用2.5 mm硬质支气管镜将一颗花生放入21只兔的呼吸道。动物分为3组(I~III组)，分别于FB植入后第3、10、30天处死动物，因FB植入前各组无差异，处死前行肺CT扫描，取肺组织进行光镜下组织学分析。第1组以支气管壁周围白细胞浸润(P=0.0003)和肺泡间隔周围水肿(P=0.0384)为主。CT扫描正常。第11组和第111组支气管壁周围单核细胞和巨噬细胞浸润增多(P=0.0008，P=0.0409)。在肉芽肿形成、肺气肿、肺不张或肺泡间隔厚度方面，三组之间没有差异。IF组的CT表现为病变肺内有实变和微小的支气管扩张(P<0.05)。Ⅲ组7只兔中有4只出现了支气管软骨的破坏(P=0.0071)。我们认为，花生在支气管内滞留30天会导致支气管软骨的破坏和纤维化，这是由于肺实质的气道扩张所致。因此，任何怀疑有异物吸入的病例都应立即治疗，以防止可能发生的不可逆转的肺部改变。儿科肺单醇。2002年；33：362-367。(C)2002年Wiley-Liss，Inc.
Unrecognized bronchial foreign bodies (Fbs) cause irreversible changes in the airways. However, Vie exact course of these changes is not well-known. We developed an animal model of bronchial obstruction to radiologically and histopathologically assess the development of postobstructive pulmonary changes. A piece of peanut was placed in the airways of 21 rabbits through a 2.5-mm rigid bronchoscope. Animals were divided into three groups (groups I-III) that were sacrificed on day 3,10, and 30 after Fb placement, respectively.Prior to sacrifice, since there were no differences between the groups prior to Fb placement, computerized tomography (CT) of the lung was taken, and the lungs were harvested for histologic analysis under light microscope. In group 1, leukocyte infiltration around the bronchial wall (P = 0.0003) and edema (P = 0.0384) around the alveolar septa were the predominant histological findings. The CT scan was normal. In group 11 and group 111, increased amounts of mononuclear cells and macrophage infiltration around the bronchial wall were observed (P = 0.0008, P = 0.0409, respectively). There were no differences in presence of granuloma formation, emphysema, atelectasis, or thickness of alveolar septa among the three groups. The CT scan of group If showed consolidations plus minimal bronchial dilatation in the involved lung of the rabbits (P not significant). Bronchial cartilage destruction was seen in 4 out of 7 rabbits in group III (P = 0.0071).We conclude that 30-day retention of intrabronchial peanut caused bronchial cartilage destruction and fibrosis that were attributed as bronchiectatic changes in the airways of the lung parenchyma. Therefore, any case with suspected foreign body aspiration should be treated immediately to prevent possible irreversible changes of the lungs. Pediatr Pulmonol. 2002; 33:362-367. (C) 2002 Wiley-Liss, Inc.