高频振荡通气及肺泡表面活性物质对吸入性损伤兔肺组织的影响  

The effects of high frequency oscillatory ventilation （HFOV） and HFOV combined with pulmonary surfactant treatment on lung tissue of rabbits with steam inhalation injury

作　　者：付忠华[1] 郭光华[1] 吴星恒[2] 杨明[2] 

机构地区：[1]南昌大学第一附属医院烧伤科,江西330006 [2]南昌大学第一附属医院儿科,江西330006

出　　处：《中国危重病急救医学》2009年第11期641-643,I0001,共4页Chinese Critical Care Medicine

基　　金：国家自然科学基金项目（30460134）

摘　　要：目的比较高频振荡通气（HFOV）与HFOV联合肺泡表面活性物质（PS）对重度蒸汽吸入性肺损伤兔肺组织的保护作用。方法将24只新西兰大白兔制成重度蒸汽吸入性肺损伤模型后，按随机数字表法分为3组，每组8只。分别给予常规机械通气（CMV）、HFOV、HFOV＋气管内滴入外源性PS（100mg／kg）治疗；通气4h后处死动物，取肺组织观察组织病理变化，并行肺组织损伤评分。结果肺大体标本、光镜下及电镜下均观察到HFOV后肺损伤程度较CMV明显减轻，3组中以HFOV＋PS组损伤最轻，CMV组损伤最重；肺组织损伤评分也显示CMV组最高[（3．71±0．43）分]，HFOV＋PS组最低[（2．08±0．28）分]，HFOV组居中[（2．87±0．26）分]，两两比较差异均有统计学意义（P〈0．05或P〈0．01）。结论与CMV比较，HFOV通过减少肺组织内炎性细胞浸润及水肿液的渗出，可减轻吸入性肺损伤，且HFOV联合PS作用最明显。Objective To investigate the effects of high frequency oscillatory ventilation （HFOV） and HFOV combined with pulmonary surfactant （PS） treatment on lung tissue after steam inhalation injury in rabbits. Methods Twenty-four New Zealand rabbits were randomly and equally divided into three groups after reproduction of severe steam inhalation injury, each n = 8. Then they were ventilated by conventional mechanical ventilation （CMV）, HFOV or HFOV＋PS （100 mg/kg, drip via trachea）, respectively. Animals were sacrificed after 4 hours, then the middle lobe in the right lung were excised for histological sections and the degree of injury was assessed. Results Histological injury in rabbits of HFOV groups were less serious than the CMV group. Among three groups, histological injury in rabbits of CMV group was most evident and least in the HFOV＋PS group. It was also found that in CMV group showed the highest score of histological injury （3.71±0.43）, and the lowest was found in HFOV＋PS group （2.08±0.28）, and that of HFOV group was 2.87± 0. 26. Comparison between whichever two of the three groups showed statistical significance （P〈0.05 or P〈0.01）. Conclusion HFOV can alleviate pulmonary edema and infiltration of inflammation cells, and it is shown that HFOV combined with exogenous PS gives the best outcome.

关 键 词：肺炎 吸入性 肺损伤 高频振荡通气 常规机械通气 肺泡表面活性物质 

分 类 号：R686[医药卫生—骨科学]