高频通气对海水淹溺肺水肿肺弥散功能的影响  

Effect of high frequency jet ventilation on pulmonary diffusion function in pulmonary edema after seawater drowning

作　　者：董文度[1] 赵增荣[1] 张敏华[1] 王琰[1] 刘虹[1] 袁驾南[1] 徐根兴[1] 

机构地区：[1]海军医学高等专科学校细胞生物学研究室

出　　处：《中华劳动卫生职业病杂志》1999年第2期91-94,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：总后勤部科研基金

摘　　要：目的探讨高频喷射通气（ＨＦＪＶ）对海水淹溺肺水肿（ＰＥＳＷＤ）肺弥散功能的影响，对ＰＥＳＷＤ进行ＨＦＪＶ治疗。观察和分析了ＨＦＪＶ对ＰＥＳＷＤ肺弥散功能的影响，探讨ＨＦＪＶ的治疗机制。方法应用血气酸碱分析仪和计算机图像分析系统，对兔动脉血气酸碱６项指标和肺毛细血管内皮细胞Ｎａ＋Ｋ＋ＡＴＰａｓｅ９项参数进行自动检测和定量测量。结果ＨＦＪＶ组ＰａＯ２、血氧饱和度（ＳＯ２）、ｐＨ、实际碳酸氢盐（ＡＢ）、碱剩余（ＢＥ）和肺毛细血管内皮细胞Ｎａ＋Ｋ＋ＡＴＰａｓｅ活力均比ＰＥＳＷＤ组明显升高（Ｐ＜０．０１或Ｐ＜０．０５）。但每项指标均未能恢复到灌海水前的正常水平。ＰａＣＯ２在两组之间差异无显著性。结论ＨＦＪＶ可较好地增加ＰＥＳＷＤ肺泡弥散面积，减少弥散膜的厚度，调节肺泡通气与血流（ＶＡ／Ｑ）比例失调，改善肺的弥散功能。若与其它救治措施综合应用。Objective To study the effect of high frequency jet ventilation(HFJV) on pulmonary diffusion function in pulmonary edema after seawater drowning(PE SWD) and treatment mechanism of HFJV. Methods 6 indexes of blood gas and acid base and 9 parameters of Na + K + ATPase in the endothelial cells of the lung capillaries were observed and measured by the blood gas analyser and computer image analysing system. Results PaO 2,oxygen saturation(SO 2),pH,actual bicarbonate(AB),base excess(BE) and Na + K + ATPase activity in the endothelial cells of the lung capillaries in HFJV group are significantly higher than in PE SWD group( P <0.01 or P <0.05).But they did not all recover to normal level before instillation. PaCO 2 in PE SWD group was not obviously different from that in HFJV group. Conclusions HFJV treatment may increase the area of alveolus diffusion,decrease the thickness of diffusion membrane,regulate V A/Q imbalance and improve pulmonary diffusion function.If HFJV combines with other measures,better therapeutic effect may be obtained.

关 键 词：高频喷射通气 肺水肿 海水淹溺 血气分析 PE-SWD 

分 类 号：R541.630.5[医药卫生—心血管疾病] R605.973[医药卫生—内科学]