单侧、双侧肺减容术后肺气肿兔动脉血气与肺通气功能的变化  

Comparative study on arterial blood gas analysis and pulmonary functions of emphysematous rabbits after unilateral and bilateral lung volume reduction surgery

作　　者：谭群友[1] 邓波[1] 李东亮[1] 龚太乾[1] 陶绍霖[1] 王如文[1] 蒋耀光[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所胸外科中心,重庆400042

出　　处：《中华胸心血管外科杂志》2011年第9期561-563,565,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：本课题为重庆市科委自然科学基金计划资助项目（2007BB5092）

摘　　要：目的比较单侧、双侧肺减容术后肺气肿家兔动脉血气与肺通气功能的变化。方法60只家兔随机分为正常对照（A组）、肺气肿（B组）、单侧假手术（C组）、单侧肺减容术（D组）、双侧假手术（E组）和双侧肺减容术（F组）。除A组外，其余均采用吸烟加气管内滴注木瓜蛋白酶的方法制作成肺气肿模型。术后8周进行动脉血气分析和肺功能检查。结果与B组比较，D组pH、氧分压（PaO2）和氧饱和度（SaO2）显著升高（P〈0．05），PaCO2显著降低（P〈0．05）；F组pH、PaO2和SaO2显著升高（P〈0．01），PaC02显著降低（P〈0．01）。与D组比较，F组pH、Pa02和SaO2显著升高（P〈0．05），PaCO2显著降低（P〈0．05）。与B组比较，C组和E组肺功能无显著性差异（P〉0．05）；D组0．5S用力呼气容积（FEV0.5）和FEV0.5／FVC（用力肺活量）显著升高（P〈0．05），功能残气量（FRC）／TLC（肺总容积）、动态顺应性（Cld）和呼气相气道阻力（Re）显著降低（P〈0．05）；F组FEV0.5和FEV0.5／FVC显著升高（P〈0．01），FRC／TLC、Cld和Re显著降低（P〈0．01）。与13组比较，F组FEV¨和FEV。5／FVC显著升高（P〈0．05），FRC／TLC、Cld和Re显著降低（P〈0．05）。观察期内双侧肺减容术组兔死亡2只，其余各组兔均存活。结论双侧肺减容术较单侧肺减容术更能改善动脉血气和肺通气功能。Objective Describes the changes of arterial blood gas analysis and pulmonary functions of emphysematous rabbits after unilateral and bilateral lung volume reduction surgery. Methods Sixty rabbits were randomly and equally divided into 6 groups： control group （A）, emphysema group （B）, unilateral sham operation group （C）, unilateral lung volume reduction surgery group（ D）, bilateral sham operation group（E） and bilateral lung volume reduction surgery group（F）. Obstructive emphysema was induced with somg and papain in the rabbits of the remaining groups except the control one. Eight weeks later, arterial blood gas analysis and pulmonary functions were detected. Results Compared with group B, pH, PaO2 , PaCO2 , SaO2 , forced expiratory volume in 0.5 s, froced expiratory capacity, functional residual capacity, total lung capacity, dynamic compliance, and resistance in expiartory phase could be improved in group D （ P 〈 0.05 ）. The amelioration of those results were more obvious in group F （P 〈 0.05 ）. Two rabbits in group F died after opertation. Conclusion Bilateral lung volume reduction surgery could more markedly improve the arterial blood gas analysis and pulmonary functions of emphysematous rabbits than unilateral operation.

关 键 词：肺气肿 阻塞性 肺切除术 动脉血气分析 肺功能 兔 

分 类 号：R655.3[医药卫生—外科学]