Experimental study for in utero repair of congenital diaphragmatic hernia

先天性膈疝宫内修复的实验研究

• 批准号: 02454323
• 负责人: KATO Tetsuo
• 金额: $ 0.77万
• 依托单位: Akita University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1990
• 资助国家: 日本
• 起止时间: 1990 至 1992
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-02454323/
• 关键词: congenital diaphragmatic hernia; intra-uterine repair; hypoplastic lung; surfactant in the lung; DNA in the lung; histology of the lung; lung faction

To study the efficacy and feasibility of in utero repair of congenital diaphragmatic hernia, we produced and repaired diaphragmatic hernias in fetal rabbits.Diaphragmatic hernias were produced in 90 fetal rabbits at 22 days gestation (term=31 days) via a left thoracotomy. The diaphragmatic hernias were repaired at 25 days gestation in 50 rabbits, 20 of which subsequently died. The rabbits with repaired or unrepaired diaphragmatic hernia were dilivered at 29 days gestation by caesarean section.The sacrificed rabbits were subjected to measurements of P-V curve and lung compliance, measurements of body and lung weight, determination of DNA and surfactant (DSPC and PG) content in the lungs, and histological examination of the lung.The total lung weight/body weight ratio and total lung DNA content in the repaired group were greater than those in the unrepaired group. There was no difference between the 2 groups in body weight and surfactant content. Histologically, the lung acini and terminal air spaces were more mature in the repaired group than in the unrepaired group. Lung compliance in the repaired group was greater than that in the unrepaired group.In conclusion, in utero repair of congenital diaphragmatic hernia is morphologically and functionally effective in improving the hypoplasticity of the lung which accompanies this lesion.

为了研究子宫内修复先天性膈疝的有效性和可行性，我们制作并修复了胎兔的膈疝。90只胎兔妊娠22天（足月31天）经左开胸产生膈疝。50只兔在妊娠25天修复膈疝，其中20只死亡。将膈疝修复或未修复的兔于妊娠29天剖宫产。测定P-V曲线和肺顺应性，测定体重和肺重，测定肺中DNA和表面活性物质（dsc和PG）含量，并进行肺组织学检查。修复组肺总重/体重比和肺总DNA含量均大于未修复组。两组间体重和表面活性剂含量无显著差异。组织学上，修复组肺腺泡和末端气隙较未修复组成熟。修复组肺顺应性高于未修复组。综上所述，子宫内修复先天性膈疝在形态学和功能上都能有效改善该病变所伴随的肺可塑性低下。

项目成果

Kato T.et al: "Histometry and Three-dimensional Image Re-constriction of the Lung in Congenital Diaphragmatic Hernia" Pediatr.Surg.Int.

Kato T. 等人：“先天性膈疝肺部的组织测量和三维图像重建”Pediatr.Surg.Int。

Kato,T.: "Evaluation of the lung in congenital diaphragmatic hernia by histometry and three dimensional image reconstruction" J.Pediatr,Surg.

Kato,T.：“通过组织测量和三维图像重建对先天性膈疝的肺部进行评估”J.Pediatr，Surg。

Kato, T.: "Fetal surgery for congenital diaphragmatic hernia" J.Pediatr. Pract.57. 209-212 (1994)

Kato, T.：“先天性膈疝的胎儿手术”J.Pediatr。

加藤 哲夫: "先天性横隔膜ヘルニア肺の組織計測および三次元再構築による検討" 日本界面医学会雑誌. 21. 118-125 (1990)

Tetsuo Kato：“先天性膈疝肺的组织测量和三维重建”日本界面医学会杂志 21. 118-125 (1990)。

加藤哲夫,他: "胎児、未熟児の外科と治療、先天性横隔膜ヘルニア" 小児科診療. 57. 209-212 (1994)

Tetsuo Kato 等人：“胎儿、早产儿和先天性膈疝的手术和治疗”《儿科学》57. 209-212 (1994)。