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

1.粘膜损伤程度与从家兔体内吸出的组织碎片之间的关系从家兔体内取出气管，通过放置在标本收集容器中的导管对粘膜进行抽吸。吸痰后的气管组织标本和吸痰容器内痰涂片细胞学标本均显示基底膜损伤。Papanicolaou（PAP）染色上皮细胞红色和固有层绿蓝色。细胞角蛋白14抗体（CK 14）将基底细胞染成棕色。Elastica货车Gieson（EVG）将弹性纤维染成黑色，胶原纤维染成红色。PAS染色的细胞学标本显示上皮细胞和胶原纤维，EVG染色的标本显示弹性纤维和胶原纤维，CK 14染色的标本显示棕色染色的上皮细胞和基底细胞。上皮细胞、基底细胞、当粘膜损伤到达固有层时，在抽吸的标本中可见弹性和胶原纤维。我们认为PAP染色适用于观察上皮细胞，CK 14染色适用于观察基底细胞，EVG染色适用于观察弹性纤维和胶原纤维.从患者的抽吸组织碎片中估计粘膜损伤程度从7例患者的痰涂片中制备细胞学标本。抽吸压力设定为400 mmHg。PAP染色3例，CK染色4例。所有标本均显示上皮细胞，2例CK染色显示基底细胞。最大和最小抽吸压力分别为400-190 mmHg和320-140 mmHg，我们认为在此条件下气管粘膜上皮或基底细胞受到损伤。抽吸压力低于设定值，表明所有3个导管孔均未闭合，但高于2个导管孔闭合时观察到的抽吸压力。

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.