高频振荡通气对胎粪性急性肺损伤的影响  

Influence of High Frequency Oscillation Ventilation to Pathological Change During Meconium Induced Lung Injury

作　　者：朱晓东[1] 陈菲[1] 张忠德[2] 谢利娟[1] 沈艺[1] 朱建幸[1] 

机构地区：[1]上海第二医科大学新华医院上海儿童医学中心儿内科,上海200092 [2]上海第二医科大学新华医院上海儿童医学中心病理科,上海200092

出　　处：《上海第二医科大学学报》2005年第11期1093-1096,共4页Acta Universitatis Medicinalis Secondae Shanghai

基　　金：上海市高等学校青年科学基金(02BQ29)资助项目

摘　　要：目的胎粪性急性兔肺损伤模型通过高频振荡通气(HFOV)干预,观察其肺组织病理变化,探讨HFOV的应用价值和基础理论。方法28只健康新西兰兔随机分对照组(n=6)、常频组(n=7)、高频组(n=9)和正常组(n=6),机械通气6 h后对兔肺进行病理学检查。结果HFOV组的炎性细胞浸润、水肿及小气道损伤均比常频组轻,各组均未见肺透明膜形成。结论针对胎粪性急性肺损伤,HFOV比常频通气可能更有利减轻肺组织损伤,提示临床治疗胎粪吸入综合征时HFOV可能比常频通气更具优越性。Objective To investigate the therapeutic foundation of HFOV on rabbit models with ALI induced by meconium through the observation on pathological changes in lungs and to highlight the feasibility of clinical application of HFOV. Methods Twenty-eight rabbits were randomly divided into groups as controls （n = 6） , conventional ventilated （CV）（ n = 7 ） and HFOV （n = 9） after ALI induced by meconium was established and the normal group （n = 6） too, Six hours after the intervention the pathological changes of lung tissue was examined under microscope. The variances of pathologic change were analyzed by Kruskal-Wallis （K-W）. Results The pathological changes such as infiltration of the inflammatory cells, edema injury of micro airways was significantly severe in CV group than those in HFOV group. The formation of hyaline membrane was not found in all groups. Conclusion HFOV is effective than the CV for decreasing lung injury when treating ALI caused by meconium indicating that HFOV is more feasible for clinical application and thus should be selected for use as the main clinical techniques when treating neonates with MAS.

关 键 词：胎粪吸入综合征 急性肺损伤 高频振荡通气 病理学 

分 类 号：R722.1[医药卫生—儿科]