热缺血期间持续通气对无心跳兔肺的保护作用  

Protective effect of ventilation during warm ischemia on rabbit lung in non-heart-beating donors

作　　者：杨鸿生[1] 叶卫华[1] 任琼辉 何建超[1] 刘长春[1] 孙嘉智[1] 

机构地区：[1]昆明医学院第一附属医院心胸外科,650031 [2]云南省交通厅医院

出　　处：《中华器官移植杂志》2004年第5期279-282,共4页Chinese Journal of Organ Transplantation

摘　　要：目的研究热缺血期间持续通气对无心跳供者(NHBD)的肺的保护作用。方法将12只日本大耳白兔作为供者,随机分为两组,在无肝素抗凝处理条件下处死动物,经历热缺血1h。对照组热缺血期间不给予通气,实验组热缺血期间给予持续通气,然后均以4℃EuroCollins液灌洗,冷保存2h。另取同种兔12只,建立离体兔肺灌注模型,对保存的兔肺进行再灌注。分别评价血流动力学、肺泡细胞生存能力、组织学改变、血液气体分析及湿干比。结果实验组与对照组相比,肺血管阻力较低,肺泡细胞生存能力较高,肺血管内血栓数较少,动脉血氧分压较高,湿干比较低。病理学检查,实验组肺损伤程度较对照组轻。结论热缺血期间的持续通气对无肝素抗凝处理的无心跳供者的肺具有明显的保护作用。Objective To investigate the effect and mechanism of ventilation during warm ischemia on rabbit lung in non heart beating donors without heparinization. Methods Twelve Japanese big ear rabbits as donors were randomly divided into 2 groups. They were sacrificed with an intravenous injection of potassium chloride on the condition of non heparinization. In control group ( n =6), the ventilation was not given during warm ischemia. In the treatment group ( n =6), the ventilation was kept during warm ischemia. The rabbit's lung was flushed with cool Euro Collins solution when the warm ischemia lasted 1 h. Donor lungs were retrieved and stored at 4 ℃ for 2 h . Through the establishment of the isolated rabbit lung reperfusion model, the hemodynamics, lung cell viability, ventilatory, W/D and morphology were evaluated. Results The mean pulmonary artery pressure, pulmonary vascular resistance and W/D were significantly lower in the treatment group in the control group. On the other hand, the lung cell viability and P aO 2 were significantly greater in the treatment group than in the control group. Histologic examination showed that there were significantly less thrombsis in pulmonary vascular and relatively milder damage in lung parenchymal in the treatment group than in the control group. Conclusion The ventilation during warm ischemia has markedly protective effects on rabbit lung in non heart beating donor without heparinization.

关 键 词：热缺血 通气 保护作用 供者 对照组 肺泡细胞 无肝素 生存能力 结论 实验 

分 类 号：R655.3[医药卫生—外科学]