保护性通气策略治疗海水淹溺急性肺损伤兔的实验研究  

The effects of protective lung ventilation strategy treatment on acute lung injury model induced by seawater drowning in rabbits

作　　者：刘于红[1] 韩志海[2] 段蕴铀[2] 张志诚[2] 冯华松[2] 

机构地区：[1]第二军医大学海军临床医学院 [2]海军总医院

出　　处：《中国急救医学》2008年第10期906-910,共5页Chinese Journal of Critical Care Medicine

基　　金：海后司令部科研计划课题(No.06-3305)

摘　　要：目的观察保护性肺通气策略在海水淹溺急性肺损伤应用时的治疗作用和安全性。方法应用保护性机械通气策略对SWD-ALI兔进行分组救治,在不同时间点观察血气分析、呼吸动力学、血液动力学、肺损伤指标,并进行肺组织学检查,以评价治疗效果和安全性。结果采用6～8 mL/kg小潮气量机械通气不仅能改善SWD-ALI时的氧合(P<0.05),而且能有效控制气道峰压和平台压,从而避免呼吸机相关肺损伤。结论肺保护性通气策略联合应用治疗SWD-ALI,能够明显改善氧和,避免继发肺损伤,是一种安全有效的治疗SWD-ALI的机械通气手段。Objective To observe the therapeutical effect and safety of lung protective strategy for alveolar recruitment on acute lung injury model induced by seawater drowning （ SWD -ALI） in rabbits. Methods Protective lung ventilation strategy were used in various SWD - ALI rabbits models. Blood gas analysis, pulmodynamie, hemodynamies status were monitored at various time point. Tumor necrosis factor （ TNF - α） and interleukin - 6 （ IL - 6 ） extracted from serum were measured after treatment. After 3 hours ventilation , HRCT were taken in every rabbits. Then rabbits of each groups were killed to gain lung tissues for pathology examination. Results PaO2 , dynamic pulmonary compliance significantly increased after ventilation treatment （ tidal volume 6 - 8 mL/kg ） , while mean air - way pressure, peak inspiratory pressure and airway plateau pressure markedly decreased. Conclusions Protective lung ventilation strategy is a effective and safety ventilation approach in SWD -ALI treatment.

关 键 词：保护性肺通气策略 急性肺损伤 海水 

分 类 号：R563.8[医药卫生—呼吸系统] R649.3[医药卫生—内科学]