A clinical study of safe pressure for tracheal suction-cytological analysis of the content aspirated from tracheal suction

1.兔气管黏膜损伤程度与取材组织块的关系将兔气管切开后，通过置入标本采集容器内的导管对粘膜进行吸引术。然后将吸出的气管标本与容器中收集的痰涂片的细胞学标本一起制成组织学标本，所有组织学标本均显示基底膜损伤。Papanicolaou(PAP)染色的上皮细胞为红色，固有层为绿色-蓝色。细胞角蛋白14抗体(CK14)染色基底细胞呈棕色。Elastica van Gieson(EVG)染色弹性纤维呈黑色，胶原纤维呈红色。PAS染色显示上皮细胞和胶原纤维，EVG染色显示弹性纤维和胶原纤维，CK14染色显示棕色的上皮细胞和基底细胞。当粘膜损伤到达固有层时，抽吸标本中可见上皮细胞、基底细胞以及弹性和胶原纤维。我们认为PAP染色适合于上皮细胞的观察，CK14染色适合于基底细胞的观察，EVG染色适合于弹性纤维和胶原纤维的观察。从患者的组织碎片中估计粘膜损伤的程度7例患者的痰涂片制备了细胞学标本。吸气压力设定为400毫米汞柱。PAP染色3例，CK染色4例。所有标本均为上皮细胞，2例CK染色标本均为基底细胞，吸痰开始后压力缓慢下降。最大吸气压力为400~190 mm Hg，最小吸气压力为320~140 mm Hg，我们认为在此情况下气管黏膜上皮细胞或基底层细胞受到损伤。抽吸压低于设定值，说明3个导尿管孔均未闭合，但高于闭合2个导尿管孔时的值。

1. Relationship between degree of mucous membrane injury and tissue fragments aspirated from rabbitsTracheae were removed from rabbits, and suction was applied to the mucous membranes via a catheter placed in a specimen collection container. The suctioned tracheae were then prepared into histological specimens, together with cytological specimens from smears of sputum that had been collected in the container.All histological specimens showed basal membrane injury. Papanicolaou (PAP) stained epithelial cells red and the lamina propria green-blue. Cytokeratin 14 antibody (CK14) stained basal cells brown. Elastica van Gieson (EVG) stained elastic fibers black and collagen fibers red.Cytological specimens stained by PAS showed epithelial cells and collagen fibers, those stained by EVG showed elastic fibers and collagen fibers, and those stained for CK14 showed brown-stained epithelial and basal cells.Epithelial cells, basal cells, and elastic and collagen fibers were evident in aspirated specimens when the mucous membrane injury reached the lamina propria. We consider that PAP staining is suitable for observation of epithelial cells, CK14 for basal cells, and EVG for elastic fibers and collagen fibers.2. Degree of mucous membrane injury estimated from tissue fragments aspirated from patientsCytological specimens were prepared from sputum smears from 7 patients. The suction pressure was set at 400 mmHg. Three specimens were stained by PAP, and 4 for CK. All specimens showed epithelial cells, and 2 specimens stained for CK showed basal cells.The pressure fell slowly after the start of suction. Maximum and minimum suction pressures were 400-190 mmHg and 320-140 mmHg, respectively.We considered that epithelial or basal cells in the tracheal mucous membrane were injured under these conditions. The suction pressure was lower than the set value, indicating that all 3 catheter holes were not closed, but was higher than that observed when 2 catheter holes were closed.