全氟化碳汽化吸入对急性呼吸窘迫综合征猪血气及血流动力学的影响  

Effects of vaporized perfluorocarbon inhalation on blood gas and hemodynamics in piglet model of acute respiratory distress syndrome

作　　者：王晓光[1] 张健鹏[2] 赵晓巍[2] 刘又宁[3] 杨海波[1] 于红[1] 

机构地区：[1]解放军313医院呼吸内科,辽宁葫芦岛125000 [2]武警总医院呼吸内科 [3]解放军总医院呼吸内科

出　　处：《解放军医学杂志》2009年第6期746-748,共3页Medical Journal of Chinese People's Liberation Army

基　　金：国家“十五”科技攻关课题(2003BA712A07-01)

摘　　要：目的探讨全氟化碳(PFC)汽化吸入对十六烷磺基丁二酸钠(SDOSS)诱导的急性呼吸窘迫综合征(ARDS)模型猪血气及血流动力学的影响。方法选取16只猪复制ARDS模型,确定模型复制成功后随机均分为实验组和对照组。实验组在给予常规机械通气(CMV)的同时给予PFC汽化吸入治疗2h,治疗结束继续给予CMV6h;对照组给予CMV治疗8h。观察两组实验动物均在气管插管即刻(基础值)、造模成功即刻、PFC吸入结束即刻及PFC吸入结束后2、4、6h的氧合指数(PaO2/FiO2)、动脉二氧化碳分压(PaCO2)、pH值以及心率和平均动脉压。结果造模成功即刻,实验组的PaO2/FiO2由基础值的365.9±24.9降至134.1±33.6,对照组由367.5±39.8降至112.1±16.7(P<0.05);PFC吸入结束即刻,实验组升至239.9±76.8,对照组为137.3±26.8,两组差异显著(P<0.01);PFC吸入结束后6h,实验组升至279.8±65.2,对照组为145.1±47.0,两组差异显著(P<0.01)。治疗及观察期间,对照组的心率进行性增加,平均动脉压在PFC吸入结束后2～6h显著降低;与对照组比较,实验组的心率在PFC吸入结束后6h时点才有显著降低(P<0.05),其平均动脉压在PFC吸入结束即刻及其后各时点均有所增加(P<0.05)。两组的pH值及PaCO2在整个实验期间无显著变化。结论PFC汽化吸入能明显改善SDOSS所致ARDS猪的氧合,并稳定血流动力学,且这种改善及稳定作用在治疗结束后仍能持续6h。Objective To explore the effects of vaporized perfluorocarbon （PFC） inhalation on blood gas and hemodynamics in sodiurn dioctyl sulfosuccinate （SDOSS）-induced acute respiratory distress syndrome （ARDS） in piglet. Methods ARDS model was successfully established in 16 piglets, which were then randomized into experimental group and control group. The experimental group was managed with conventional mechanical ventilation（CMV） accompanied with vaporized PFC inhalation for 2 hours, subsequently with CMV for another 6 hours, and the control group with CMV for the whole 8 hours. Oxygenation index （PaO2/FiO2）, arterial carbon dioxide tension （PaCO2）, pH, heart rate （HR） and mean arterial pressure （MAP） were measured at the moment of tracheal intubation （baseline time point）, establishment of ARDS model, and 0, 2, 4, 6 hours after the end of PFC inhalation. Results At the moment of establishment of ARDS model, PaO2/FiO2 ratio of experimental group decreased from 365. 9±24. 9 to 134. 1±33. 6, and that of control group decreased from 367. 5 ±39.8 to 112. 1 ± 16. 7 （P〈0. 05）. At the moment of the end of PFC inhalation, PaO2/FiO2 ratio of experimental group was increased to 239. 9±76.8, while that of control group remaind to be 137. 3±26. 8, showing a significant difference between the two groups （P〈0.01）. Six hours after PFC inhalation, the PaO2/FiO2 ratio of experimental group was increased to 279. 8±65. 2, whereas that of control group to 145. 1±47. 0, showing a significant difference between the two groups （P〈0. 01）. During the period of treatment and observation, HR of control group increased gradually, and MAP decreased significantly within 2-6 hours after the end of PFC inhalation. Compared with that of control group, HR of experimental group was lowered significantly 6 hours after PFC inhalation （P〈0. 05）, and the MAP rose in each of time points after PFC inhalation （P〈0. 05）. No obvious changes were found between the two groups with respect to

关 键 词：汽化全氟化碳 急性呼吸窘迫综合征 成人 血气分析 血液动力学现象 

分 类 号：R563.9[医药卫生—呼吸系统] R452[医药卫生—内科学]