完全液体通气减轻乳猪体外循环术后肺炎症反应的实验研究  

Total liquid ventilation reduces lung inflammatory reaction in piglets after cardiopulmonary bypass

作　　者：姜力骏 王强[1] 刘迎龙[1] 沈向东 杜茗 谢宁 吴松 

机构地区：[1]中国医学科学院心血管病研究所阜外心血管病医院先心病研究室 [2]现在浙江大学医学院附属第一医院胸心外科310003

出　　处：《中华胸心血管外科杂志》2006年第5期318-320,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家十五科技攻关项目(2002BA709B09);国家自然科学基金(30471721)资助

摘　　要：目的探讨以全氟化碳为载体的完全液体通气对乳猪体外循环(CPB)术后肺气体交换及炎症反应的影响。方法CPB术后肺损伤的乳猪分为完全液体通气组和传统机械通气组,每组6只。分别在CPB前、CPB后每30min行动脉血气分析。通气4h后取右下肺行支气管肺泡灌洗,检测灌洗液白细胞介素6、8和髓过氧化物酶水平并行细胞计数;取左下肺行病理分析。结果两组动脉血氧分压和二氧化碳分压比较差异无统计学意义。实验组肺泡灌洗液白细胞介素6(53.55±15.48)pg/ml对(81.32±15.23)pg/ml(P<0.05),髓过氧化物酶浓度(50.00±7.37)U/L对(75.00±9.19)U/L(P<0.05),均显著低于机械通气组;而白细胞介素8水平两组比较差异无统计学意义。光镜检查显示完全液体通气组肺组织损伤明显减轻。结论完全液体通气能维持乳猪CPB术后正常的气体交换功能;可明显减轻乳猪CPB术后肺部炎症反应和组织学损伤。Objective To investigate the effect of total liquid ventilation on pulmonary inflammatory reaction in piglets after cardiopulmonary bypass, Methods After receiving cardiopulmonary bypass operation, 12 piglets were randomly treated with conventional gas ventilation or total liquid ventilation for 240 minutes. Samples for blood gas analysis were collected before and at 30-minute interval after cardiopulmonary bypass. The degree of lung injury was analyzed histologically. The inflammatory cells and the levels of interleukin-6, interleukin-8, and myeloperoxidase in bronchoalveolar lavage were analyzed. Results Normal gas exchange was maintained during total liquid ventilation. Nuetrophil and macrophage count in bronchoalveolar lavage and histological lung injury were significantly reduced in the study group. The concentrations of interleukin-6, myeloperoxidase in bronchoalveolar lavage were reduced in the study group [（53.55±15.48） vs. （81.32±15.23） pg/ml, （50.00±7.37） vs. （75.00±9.19） U/L], P〈0.05, respectively, whereas the interleukin-8 levels were similar. Conclusion Total liquid ventilation reduces biochemical and histologic lung inflammatory reaction after cardiopttlmonary bypass.

关 键 词：液体通气 体外循环 肺通气 呼吸窘迫综合征 

分 类 号：R654.1[医药卫生—外科学]