离体兔肺灌注模型的建立及不同成份保存液的肺保护研究  

The study on the the isolated lung preservation effect of the perfusion fluid blended with different compositions

作　　者：骆金华[1] 周悦[1] 徐骁晗[1] 朱秉智[1] 

机构地区：[1]南京医科大学第一附属医院心胸外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2007年第8期843-846,872,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省自然科学基金(537DA0302)

摘　　要：目的:建立离体兔肺灌注模型,研究不同成分保存液对离体兔肺的保存作用。方法:将30只兔分为5组分别为对照组(A组)、UW液+硝酸甘油组(B组)、UW液+前列腺素E1(C组)、UW液与自身动脉血1:2混合组(D组)、UW液与自身动脉血1:4混合组(E组)。切取兔心肺作为离体心肺模型,对心肺模型进行冷灌注、低温保存。分别在2 h和4 h取肺部分标本做电镜分析。4 h末检测肺湿干重比、肺气道压力。离体肺接呼吸机后将自身静脉血用泵从主肺动脉泵入,用负压吸引真空试管取左心房血液做血气分析。结果:E、D组对于肺组织气体交换功能的保护相当,明显优于其他组。B、C组对于肺实质细胞的气体交换功能的保护结果相当,明显优于A组。结论:本实验模型可靠,稳定性好。在UW液中加入自体动脉血对离体肺灌注可以使肺保存时间明显延长、肺气体交换功能保存良好,明显优于其他组。在UW液中加入前列腺素E1和硝酸甘油对离体肺保护作用再次得到肯定,明显好于对照组,但和自体动脉血组相比仍有不足。Objective：To establish lung perfusion model of rabbit in vivo.and to investigate the isolated lung preservation effect of the perfusion fluid blended with different compositions.Methods： 30 rabbits were randomly divided into 5 groups which were control group（A）,UW fluid with glyceryltrinitrate group（B）,UW fluid with PGE group（C）,UW fluid blended with auto-artery-blood（1：2） group（D）and UW fluid blended with auto-artery-blood（1：4）group（E）.The lung and heart of rabbit were Dissociated as the isolated lung and heart model,the model were Perfused with low temperature perfusion fluid and conserved in the same temperature perfusion fluid.The lung specimens were obtained in order to analyze the change in morphology by using electron microscope at 2 and 4 hours after perfusion,the ratio of wet/dry weight（W/D）,airway pressure（AWP）of lung model Detectd; were the blood which was pumped into the lung model through main pulmonary artery and then was elicited from atrium pulmonale by using a vacuum aspiration tube were detected after 4 hours of perfusion.Results：The difference of protection to the function of lung tissue gas exchange in E and D group was not remarkable,The protective effect to the function of the lung tissue gas exchange in E and D group surpasses the protective effect of other group significantly.There was no notable difference on the protective effect to the function of lung tissue gas exchange between B and C group.But the result of B and C group shows more superiority to group A. Conclusion：The experimental model was good in reliability and constancy.The group adding auto-artery-blood to the UW perfusion fluid can get longer time of preservation and better preservation effect of the function of lung tissue gas exchange than other group. Compared with the pure UW perfusion fluid group,the superiority of the preservation effect of perfusion fluid with glyceryltrinitrate and PGE to the function of lung is demonstrated again.But the preservation effect of the perf

关 键 词：肺灌注 肺保护 肺气道压 动物模型 

分 类 号：R743.31[医药卫生—神经病学与精神病学] Q74[医药卫生—临床医学]