部分液体通气对油酸型兔急性肺损伤的治疗作用及其CT影像学表现  

Effects of partial liquid ventilation on oleic acid-induced acute lung injury rabbits and its CT features

作　　者：宋鹏[1] 李琦[1] 黄志坚[1] 钱桂生[1] 

机构地区：[1]第三军医大学新桥医院呼吸内科研究所,重庆400037

出　　处：《中国呼吸与危重监护杂志》2006年第5期349-352,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：全军"十一五"重点课题资助项目(2006G083)

摘　　要：目的观察部分液体通气对油酸型兔急性肺损伤的治疗作用及肺部CT影像的变化。方法16只健康成年大白兔经油酸致伤后随机分为二组,常规机械通气组和部分液体通气(PLV)组,每组8只,于各观察时相点检测动脉血气、肺静态顺应性,并于治疗前后行肺部CT扫描。结果PLV组PaO2从(109±22)mmHg升高到(194±38)mmHg(P<0.05),PaCO2从(53±7)mmHg降低到(45±7)mmHg(P<0.05),肺静态顺应性从(1.3±0.3)mL/cmH2O升高到(1.7±0.3)mL/cmH2O(P<0.05),血气指标及肺顺应性的改善均优于常规机械通气组。CT显示油酸型兔急性肺损伤兔肺组织呈现明显的重力依赖性分布,全氟化碳主要分布在肺的重力依赖区。结论部分液体通气治疗急性肺损伤时,全氟化碳在肺内的分布是不均一的,主要分布于肺的重力依赖区,与肺的损伤部位一致,有利于发挥治疗作用。Objective To investigate the effects of partial liquid ventilation （PLV） with perfluorocarbon （PFC） on the oleic acid-induced acute lung injury rabbits and its CT features. Methods Sixteen healthy white rabbits were randomly allocated to two groups and treated with various methods after oleic acid acute lung injury model was established. The control group was treated by conventional mechanical ventilation and the treatment group was treated by partial liquid ventilation with perfluorocarbon. The parameters such as PaO2, PaCO2 and static lung compliance （CLot） were observed before and 0, 1, 2, 3, 4 hours after treatment. CT scan of the lung in rabbits was performed before and after perfluorocarbon perfusion. Results In PLV group, PaO2 increased from （ 109 ± 22） mm Hg to （ 194 ±38） mm Hg （ P 〈 0.05） ,PaCO2 decreased from （53 ± 7） mm Hg to （45 ±6） mm Hg （ P 〈 0.05 ）, and CLst increased from （ 1.3± 0.3 ） mI/cm H2O to （ 1.7 ±0.3 ） mL/cm H2O （ P 〈 0.05）. CT scan showed that the lung injuiy regions were gravity-dependent distribution and the added PFC distributed predominantly in these regions. Conclusion Perfluorocarbon distributed predominantly in the dependent regions of the lung in which lung injury occur, thus a optimal therapeutical effect could be achieved.

关 键 词：急性肺损伤 部分液体通气 机械通气 动脉血氧分压 肺静态顺应性 体层摄影术 

分 类 号：R563.8[医药卫生—呼吸系统]