控制性肺膨胀对急性肺损伤绵羊吸痰后肺复张容积的影响  

Effects of sustained inflation on lung re-expansion after endotracheal suctioning in sheep with acute lung injury

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

机构地区：[1]东南大学附属中大医院危重病医学科,南京210009

出　　处：《中华急诊医学杂志》2004年第5期302-305,共4页Chinese Journal of Emergency Medicine

基　　金：江苏省卫生厅医学重点基金 (H2 0 0 10 2 ) ;江苏省13 5医学重点人才基金

摘　　要：目的　探讨控制性肺膨胀 (sustainedinflation ,SI)对急性肺损伤 (acutelunginjury ,ALI)绵羊吸痰后肺复张容积的影响。方法　内毒素静脉注射复制绵羊ALI模型 ,进行两组吸痰 ,SI组吸痰后立即予以一次SI,用P -V曲线法测定吸痰前后肺复张容积 ,同时观察吸痰前后动脉血氧合的变化。结果　非SI组吸痰前肺复张容积 (98 8± 77 6 )ml,吸痰后 3min显著降低 (6 4 3ml± 5 3 0ml,P <0 0 5 )。SI组吸痰后3min、 15min肺复张容积分别为 (12 8 1± 78 0 )ml和 (119 4± 6 1 5 )ml,均较吸痰前 (6 8 0± 5 0 3)ml显著增加 (P <0 0 5 )。非SI组动脉血氧分压 (PaO2 )在吸痰前为 (82 2± 4 6 9)mmHg ,叹痰后 15min显著降低为 (71 2± 30 3)mmHg (P <0 0 5 ) ;SI组吸痰前后PaO2 无明显变化。结论　吸痰可加重肺泡塌陷 ,SI可明显促进肺泡复张。Objective To investigate the effect of sustained inflation (SI) on lung recruited volume after endotracheal suctioning (ETS) during acute lung injury (ALI).Methods ALI sheep model was induced by intravenous infusion 3 μg/kg lipopolysaccharide (LPS).Two ETS groups were conducted.In SI group,SI ensued immediately after ETS.Lung re-expansion and arterial blood gas were measured. Results In the non-SI group, lung recruited volume descended significantly from (98.8±77.6) ml before ETS to (64.3 ±53.0) ml 3 minutes after ETS(P<0.05); and lung recruited volume was (70.6 ±50.7)ml at 15 minutes after ETS,there was no significant difference compared with the volume before ETS (P>0.05).In the SI group lung re-expansion significantly increased from (68.0± 50.3) ml before ETS to (128.1±78.0)ml at 3 minutes and (119.4±61.5) ml at 15 minutes after ETS (P<0.05). In the non-SI group,partial arterial oxygen tension (PaO 2) decreased significantly from (82.2 ± 46.9) mmHg before ETS to (71.2±30.3) mmHg at 15 minutes after ETS (P<0.05); but in the group with SI,PaO 2 after ETS did not change significantly compared with PaO 2 before ETS(P>0.05).Conclusion Alveolar atelectasis induced by ETS can be recruited by SI after ETS.

关 键 词：控制性肺膨胀 急性肺损伤 绵羊 吸痰 肺复张容积 

分 类 号：R563[医药卫生—呼吸系统]