Transbronchial lung volume reduction by diode laser heat probe (Indigo 830) for lung emphysema

通过二极管激光热探头 (Indigo 830) 减少经支气管肺体积以治疗肺气肿

• 批准号: 12671299
• 负责人: SEKINE Yasuo
• 金额: $ 2.43万
• 依托单位: Chiba University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12671299/
• 关键词: emphysema; lung volume reduction; transbronchial; heat probe

(1) Irradiation effect on pulmonary parenchyma by a heat probe (indigo 830)Under general anesthesia and unilateral ventilation, transbronchial irradiation by a heat probe was performed. Under the condition of 80 degree centigrade for 5 minutes, coagulation area was 25 by 10 mm, which was equivalent to that under 90 and 100 degrees for 5 minutes. However, Under 90 and 100 degrees, a part of the lung was changed necrosis, static compliance was decreased from 21.2 to 7.1 ml/cmH2O (33.5% reduction).(2) The best condition of pulmonary coagulation for lung volume reductionUnder the three conditions as follows, irradiation was performed and the best condition for volume reduction was evaluated. 1) Under spontaneous ventilation with lung expansion, 2) no ventilation with lung expansion and 3) no ventilation with lung collapse by thoracotomy. No heat elevation was observed under the condition #1. A small coagulation was observed under the condition #2. Well coagulation was observed under the condition #3.(3) Lung emphysema modelOne month after inhalation of 40 mg/kg of papain to a mini pig, lung mechanics (intra-bronchial air pressure, flow volume, airway resistance and compliance) was measured. Static compliance elevated from 23 +/- 3.5 ml/H2O before inhalation to 33.3 +/- 4.6 ml/H2O after inhalation(n=3). Pathologically, lung emphysema was confirmed.(4) The effect of laser irradiation on emphysema lungThe static compliance was reduced from 21.2 +/- 3.7 ml/H2O to 7.1 +/- 2.5 ml/H2O (33% reduction) after papain inhalation. After irradiation, that was re-elevation to 13.8 ml/H2O.

(1)热探针对肺实质的照射效果（靛蓝830）在全身麻醉和单侧通气条件下，经支气管热探针照射。在80℃5分钟条件下，凝固面积为25 × 10 mm，相当于在90℃和100℃5分钟条件下的凝固面积。然而，在90度和100度下，部分肺变坏死，静态顺应性从21.2 ml/cmH2O下降到7.1 ml/cmH2O（下降33.5%）。(2)肺凝血减容的最佳条件在以下三种条件下进行照射，评价最佳减容条件。1)开胸自动通气伴肺扩张，2)不通气伴肺扩张，3)不通气伴肺萎陷。在条件1下没有观察到热升高。在条件2下观察到小凝血。在条件#3下观察到良好的凝血。(3)肺气肿模型迷你猪吸入40 mg/kg木瓜蛋白酶1个月后，测量肺力学（支气管内气压、流量、气道阻力和顺应性）。静态顺应性从吸入前的23 +/- 3.5 ml/H2O上升到吸入后的33.3 +/- 4.6 ml/H2O （n=3）。病理证实为肺气肿。(4)激光照射对肺气肿的影响吸入木瓜蛋白酶后，静态顺应性由21.2 +/- 3.7 ml/H2O降至7.1 +/- 2.5 ml/H2O（降低33%）。辐照后，再次升高至13.8 ml/H2O。

项目成果

Chiyo M, Sekine Y, Iwata T, et al.: "Impact of Interstitial Lung Disease on Surgical Morbidity and Mortality for Lung Cancer : Analyses of Short and Long-Term Outcomes"Journal of Thoracic and Cardiovascular Surgery. in press. (2003)

Chiyo M、Sekine Y、Iwata T 等人：“间质性肺疾病对肺癌手术发病率和死亡率的影响：短期和长期结果分析”胸心血管外科杂志。

Sekine Y, Iwata T, Chiyo M, et al.: "Minimal Alteration of Pulmonary Function after Lobectomy in Lung Cancer Patients with COPD"Annals of Thoracic Surgery. (in press).

Sekine Y、Iwata T、Chiyo M 等人：“患有 COPD 的肺癌患者肺叶切除术后肺功能的微小改变”胸外科年鉴。

Chiyo M, Sekine Y, Iwata T, et al.: "Impact of Interstitial Lung Disease on Surgical Morbidity and Mortality for Lung Cancer : Analyses of Short and Long-Term Outcomes"Journal of Thoracic and Cardiovascular Surgery. (in press).

Chiyo M、Sekine Y、Iwata T 等人：“间质性肺疾病对肺癌手术发病率和死亡率的影响：短期和长期结果分析”胸心血管外科杂志。

Sekine Y, Iwata T, Chiyo M, et al.: "Minimal Alteration of Pulmonary Function after Lobectomy in Lung Cancer Patients with COPD"Annals of Thoracic Surgery. in press. (2003)

Sekine Y、Iwata T、Chiyo M 等人：“患有 COPD 的肺癌患者肺叶切除术后肺功能的微小改变”胸外科年鉴。