急性呼吸窘迫综合征绵羊肺复张容积测定方法的比较  

A comparison study on quantitative methods for the recruited volume in sheep with acute respiratory distress syndrome

作　　者：许红阳[1] 邱海波[1] 杨毅[1] 周韶霞[1] 孙辉明[1] 陈永铭[1] 

机构地区：[1]东南大学附属中大医院危重病医学科

出　　处：《中国危重病急救医学》2004年第7期413-416,共4页Chinese Critical Care Medicine

基　　金：江苏省医学重点基金 ( H2 0 0 10 2 ) ;江苏省 13 5医学重点人才基金 ;江苏省社会发展基金 ( BS2 0 0 0 40 9;BS990 3 2 )

摘　　要：目的　比较压力容积 (P V)曲线法与等压法测定肺复张容积的差异。方法　内毒素持续静脉注射复制绵羊急性呼吸窘迫综合征模型 ,分别用 P V曲线法与等压法测定相同呼气末正压 (PEEP)的肺复张容积。结果　等压法测定肺复张容积可以立即得出结果 ;而 P V曲线法测定肺复张容积所需时间为5～ 6 min。随着 PEEP从 5 cm H2 O(1cm H2 O=0 .0 98k Pa)增至 15 cm H2 O,两种方法测定的肺复张容积均显著增加 (P均 <0 .0 5 ) ;PEEP为 5 cm H2 O时 ,等压法与 P V曲线法所测的肺复张容积分别为 (2 5 .79±2 0 .4 8) m l和 (6 3.2 6± 5 4 .5 7) m l,两组比较无明显差异 (P>0 .0 5 ) ;当 PEEP为 10和 15 cm H2 O时 ,等压法所测肺复张容积分别为 (4 8.6 4± 30 .5 1) m l、(71.5 0± 5 8.0 9) ml,P V曲线法测得肺复张容积分别为 (14 8.14±85 .4 2 ) m l、(32 2 .86± 14 8.4 2 ) m l,等压法所测值明显小于 P V曲线所测值 (P均 <0 .0 5 )。结论　虽然等压法较为简便 ,但由于准确性较差 ,因此不能代替 PObjective To compare equal pressure method with pressurevolume curve method to quantify the recruited volume. Methods Acute respiratory distress syndrome sheep model was induced by intravenous infusion 3 μg/kg lipopolysaccharide(LPS). Recruited volume of three different levels of positive endexpiratory pressure (PEEP=5, 10, 15 cm H 2O) were measured both by pressure volume curve method and by equal pressure method. Results The time needed to measure recruited volume by pressurevolume curve method was 56 minutes, which was longer than that of equal pressure method . Recruited volume measured by the two methods increased with PEEP. No significant difference was found between the recruited volume measured by equal pressure method and by equal pressure method at PEEP of 5 cm H 2O , they were (25 79±20 48)ml vs. (63 26±54 57)ml( P >0 05), while recruited volume at PEEP of 10 cm H 2O and 15 cm H 2O measured by equal pressure method were lower than those measured by the pressurevolume curve method, they were (48 64±30 51)ml vs. (148 14±85 42)ml and (71 50± 58 09)ml vs. (322 86±148 42)ml(all P <0 05) respectively Conclusion Though equal pressure method is simple, it could not take the place of pressurevolume curve method to quantify recruited volume.

关 键 词：呼吸窘迫综合征 急性 肺复张容积 压力-容积曲线 呼气末正压 

分 类 号：R563.8[医药卫生—呼吸系统] R605.973[医药卫生—内科学]