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目的：术中定位是微小肺癌手术面临的主要难题，而原因则是肺在术中萎陷造成的巨大形变。我们从研究肺的术中萎陷着手，建立肺渐次萎陷动物模型，模拟肺在术中发生的萎陷，用以研究肺萎陷的过程、规律及影响因素，为微小肺癌的术中定位提供理论基础。本文用渐进的人工气胸模拟肺在术中的渐次萎陷过程，探讨简便、有效的肺渐次萎陷动物模型的制作方法。方法：健康成年犬12 只，随机等分入左、右侧手术组，麻醉后移至CT 扫描床，采用切小口置管和胸腔穿刺两种方式制作人工气胸。向胸膜腔内分次、定量地注射气体，使肺逐渐萎陷，直至完全萎陷。通过夹闭气管插管协助稳定肺的萎陷状态。将各萎陷状态分别进行CT 扫描。结果：所有实验犬均顺利完成实验，麻醉良好，无意外情况发生。9 只犬给予气管插管，3 只未给予气管插管；4 只犬采用切小口置管方式制作气胸，8 只采用胸腔穿刺方式。气管插管增加了模型制作难度，但有利于稳定肺的萎陷状态；胸腔穿刺方式相对操作更为简便。随着向胸膜腔内注射气体，肺缓慢而均匀地向肺门方向集中，萎陷进程满意。CT 扫描记录了肺从膨胀到萎陷的各阶段，经过后期重建再现了肺的萎陷过程。5 只犬出现并发症，均通过改变操作得以纠正，未影响实验进程。结论：本研究建立的肺渐次萎陷动物模型，能够很好地模拟肺在术中的萎陷过程，是研究术中肺萎陷的理想动物模型。

英文摘要:

Objective:Intraoperative localization for small pulmonary nodule is the main challenge of its operation, and its reason is the huge deformation caused by the deflated collapse of the lung during operation. To study the laws of lung collapse in operation, we establish an animal model of lung gradually collapse, which simulates pulmonary deflated collapse occurred during the operation. By the model we try to research the process of deflated lung, its rules and its influence factors, and to provide a theoretical basis for intraoperative localization of small pulmonary nodule. In the study, we make gradual artificial pneumothorax to simulate the gradually process of lung collapse in operation, and to explore a simple, effective method for the animal model.Methods:12 healthy adult dogs were randomly divided into the left or the right side surgical group equally. After anesthesia, they were transferred to the bed of CT scan, and then underwent operation for artificial pneumothorax by two ways (drainage tube placement or pleural puncture). Then the gas was injected into the pleural cavity quantitatively and gradually, which makes the lung collapse gradually until completely collapse finally. In the process, the collapse state of lung was assisted to stabilize through clamping the endotracheal intubation. All the collapse states underwent CT scan respectively.Results:All the dogs were completed the experiment successfully, anesthesia was well and no accident was occurred during the operation. 9 dogs were given tracheal intubation, and the other 3 were not given; 4 dogs were made artificial pneumothorax by the way of drainage tube placement, and the other 8 were made by pleural puncture. Although endotracheal intubation increases the difficulty of model making, it is conducive to the state stability of lung collapse. It is more convenient to make artificial pneumothorax by the way of thoracic puncture. With the injection of gas into the pleural cavity, lung was collapse to the hilar direction slowly and smoothly, and the collapse process is satisfactory. The process of lung from expansion to collapse state was recorded by CT scanning, and then it was reproduced by the image reconstruction in the later period. Complications occurred in 5 dogs during the experiment, but all of them were corrected by changing operation and did not seriously affected experiment.Conclusion:The animal model of lung gradual collapse established in the study can simulate the process of pulmonary collapse during operation effectively, which is an ideal animal model to study pulmonary collapse during operation.

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