急性呼吸窘迫综合征开放吸痰后行控制性肺膨胀的实验研究  

Effect of sustain inflation after open endotrachel suctioning in acute respiratory distress syndrome

作　　者：刘振国[1] 王晶[2] 徐家刚[1] 

机构地区：[1]山东省潍坊市人民医院麻醉科,山东潍坊261041 [2]解放军第八十九医院麻醉科,山东潍坊261021

出　　处：《中国医药导报》2011年第27期25-26,共2页China Medical Herald

摘　　要：目的:探讨控制性肺膨胀(SI)对Beagle犬急性呼吸窘迫综合征(ARDS)开放吸痰后的治疗效果。方法:选择共12只Beagle犬,利用油酸建立犬ARDS模型,接呼吸机予以基础通气,稳定30 min后随机进行两组吸痰。SI组吸痰后立即予以一次SI,非SI组吸痰后不予SI。监测吸痰前、吸痰后5 min、15 min、30 min的动脉血气、呼吸力学参数等。结果:非SI处理组ARDS吸痰后可能出现一过性的低氧血症加重,然而SI处理组在吸痰后低氧血症加重的现象并不明显。与非SI组比较,SI组动脉氧分压(PaO2)在5 min和15 min时间点上显著增高(P<0.05),SI组肺静态顺应性(Cst)在吸痰后5 min、15 min和30 min较吸痰前显著升高(P<0.05),并且在5 min和15 min时间点上高于非SI组(P<0.05)。结论:SI能改善ARDS开放吸痰后肺的氧合指标,改善肺顺应性。Objective： To evaluate the treatment value of sustains inflation（SI） in acute respiratory distress syndrome（ARDS） Beagle dog after open endotrachel suctioning.Methods： Twelve oleic acid-induced ARDS canine models ventilated with mechanical ventilation support were randomized into two groups after stabilizing for 30 min.Non-SI-group： did not SI in ARDS Beagle dog after open endotrachel suctioning.SI-group： SI in ARDS Beagle dog after open endotrachel suctioning.Oxygenation index,indexes of respiratory mechanics were obserced before sputum suction and 5 min,15 min,30 min after sputum suction.Results： A transient hypoxemia was worsen in 5 and 15 min after open endotrachel suctioning,but recovered rapidly in 30 min.However,there was no obvious hypoxemia worsen in SI-group.Partial pressure of oxygen in artery（PaO2） was higher than that in Non-SI-group at the time point of 5 or 15 min（P〈0.05）.Furthermore,Static lung compliance was better at the time point of 5,15 or 30 min after open endotrachel suctioning than before open endotrachel suctioning in SI-group（P〈0.05）.Conclusion： SI in acute respiratory distress syndrome（ARDS） after open endotrachel suctioning can improve oxygenation and lung compliance.

关 键 词：急性呼吸窘迫征 控制性肺膨胀 开放吸痰 氧合指数 呼吸力学 

分 类 号：R56[医药卫生—呼吸系统]