高频振荡通气结合一氧化氮吸入对急性肺损伤兔氧合的影响  

The experimental study on high frequency oscillation with nitric oxide inhalation in rabbits with acute lung injury

作　　者：耿荣[1] 陈贤楠[1] 吴冀川[1] 曾建生[1] 王莹[1] 

机构地区：[1]首都医科大学附属北京儿童医院,100045

出　　处：《中华儿科杂志》1999年第10期604-606,共3页Chinese Journal of Pediatrics

基　　金：北京市回国人员科研基金

摘　　要：目的　判断高频振荡通气（ＨＦＯ）伴低浓度一氧化氮（ＮＯ） 吸入对急性肺损伤家兔气体交换和血液动力学参数的影响。方法　用３７ ℃温盐水反复进行支气管灌洗（按每次３０ ｍｌ／ｋｇ）制成急性肺损伤模型。应用高频振荡呼吸机和１×１０－６ＮＯ吸入对１０ 只急性肺损伤家兔进行实验性治疗，并测定肺力学、血液动力学等参数。结果　ＨＦＯ＋ ＮＯ 与急性肺损伤基础值比较：ＰａＯ２／ＦｉＯ２ 比值由１５６±３２ 上升至４０５±４８（Ｐ＜ ０－０１）、氧合指数（ＯＩ）和肺内动静脉分流量（Ｑｓ／Ｑｔ） 分别由７－８ ±１－７ 和０－４１±０－０６ 下降至３－７ ±０－８ 和０－３０±０－０５（ Ｐ均＜ ０－０１）。ＨＦＯ＋ ＮＯ 与单纯ＨＦＯ 比较：ＰａＯ２／ＦｉＯ２ 比值由３７９±８６ 上升至４０５±４８（ Ｐ＜ ０－０５） 、ＯＩ和Ｑｓ／Ｑｔ 分别由５－８ ±１－９ 和０－３５ ±０－０６ 下降至３－７ ±０－８ 和０－３０±０－０５（Ｐ均＜０－０５） 。结论　ＨＦＯ＋ ＮＯ吸入可改善急性肺损伤兔的氧合，肺内分流减少，吸入１×１０－６ ＮＯ有效。应用本系统质量流量控制器，可以在高频振荡通气时提供稳定浓度的ＮＯ气体。Objective To observe the effects of low concentration nitric oxide (NO) inhalation with high frequency oscillation (HFO) on gas exchange and hemodynamics in rabbits with acute lung injury Methods Ten rabbits with acute lung injury (ALI) were ventilated by Sensor Medics 3100A high frequency ventilator, and applied with alveolar recruitment strategy Systemic oxygenation, pulmonary shunt and hemodynamics were evaluated before HFO treatment, 30 minutes after HFO inhalation and 30 minutes after HFO plus NO (1×10 -6 ) inhalation (HFO+NO) Results Compared HFO+NO with HFO treatment only, PaO 2/FiO 2 was significantly increased from 379±86 to 405±48 ( P< 0 05) at 30 minutes following HFO+NO, OI and Qs/Qt decreased from 5 8±1 9 and 0 35±0 06 to 3 7±0 8 and 0 30±0 05 ( P< 0 05), respectively Conclusion HFO+ NO might improve the systemic oxygenation and decrease the pulmonary shunt in rabbits with ALI Mass flowmeter in the NO inhalation system could prodnce a stable concentration of NO during HFO

关 键 词：高频通气 一氧化氮 吸入法 肺 创伤和损伤 

分 类 号：R563[医药卫生—呼吸系统]