星状神经节阻滞对兔机械通气所致肺损伤的保护作用  

Lung protective effects of stellate ganglion block on mechanical ventilation in rabbits

作　　者：黄再青[1] 段霞光[1] 康于庆[1] 刘慧[1] 何志强[1] 郝天兵[1] 

机构地区：[1]内蒙古包钢医院麻醉科,包头014010

出　　处：《国际麻醉学与复苏杂志》2016年第5期389-393,共5页International Journal of Anesthesiology and Resuscitation

摘　　要：目的探讨星状神经节阻滞（stellateganglionblock，SGB）对兔呼吸机相关性肺损伤（ventilatorassociatedlunginjury，VALI）的影响。方法40只成年日本大耳兔按随机数字表法分为两组（每组20只）：空白对照组（I组）和SGB组（Ⅱ组）。I组全身麻醉气管插管后椎旁注入生理盐水（0．5m1），Ⅱ组全身麻醉气管插管后给予SGB。分别于机械通气后1h（T1）、2h（T2）、4h（T3）、6h（T4）4个时间点经耳缘静脉抽取静脉血3ml后处死白兔，检测血清丙二醛（malondialdehyde，MDA）、TNF啦浓度及超氧化物歧化酶（supemxidedismutase，SOD）活性；取左肺组织测量湿，干重比（wet／dry，w／D）；取一部分右肺组织H-E染色后光镜和电镜观察其病理变化，另一部分匀浆后检测MDA含量、髓过氧化物酶（myeloperoxidase，MPO）及SOD活性。结果与I组比较，Ⅱ组肺组织的W／D[（6．07±0．12）比（8．58±0．48）]和SOD活性[（64±10）U／mg比（77±11）U／mg]明显降低（P〈0．01）；II组肺组织的MDA含量[（0．89±0．12）μmol／g比（0．63±0．11）p,mol／g]和MPO活性[（0．46±0．09）u住比（0．28±0．07）U／g]明显升高（P〈0．01）。H-E染色后光镜和电镜观察Ⅱ组肺组织病变轻于I组。与I组比较，Ⅱ组血清MDA、rTNF-a在T2～T4时间点降低（P〈0．05），Ⅱ组血清SOD在B几时间点升高（P＜如0.05）结论SGB可以减轻机械通气兔肺组织的损伤，产生肺保护作用。Objective To evaluate the effects of stellate ganglion block （SGB） on rabbit ventilator associated lung injury （VALI）. Methods Forty rabbits were randomly divided into two groups（n=20）： the control group （group I ） and the SGB group（group II ）. Group I is only given NS. Group 11 is stellate ganglion block. Wet/dry （W/D）, activities of superoxide dismutase （SOD）, myleoperoxidase（MPO）, and level of malondialdehyde（MDA） in lung tissue were detected at the time of 1 h（T1）, 2 h（T2）, 4 h（T3）, 6 h（T4） after mechanical ventilation. MDA, TNF-ct and SOD in serum were measured. Results W/D and activities of SOD in group II were both significantly lower than group I [（6.07±0.12） vs （8.58±0.48）, （64±10） U/mg vs （77±11） U/mg]（P〈0.01）, level of MDA and activities of MPO were significantly higher than group I [（0.89±0.12） μmol/g vs （0.63±0.11） panol/g, （0.46±0.09） U/g vs （0.28±0.07） U/g] （P〈O.O1）. The lung tissue lesion showed from HE staining under light microscope and electron microscope in group ]I was lighter than group I. Compared with group I, serum MDA and TNF-a of the rabbits in group II at T2-T4 time points were significantly lower （P〈0.05）. Compared with group I, serum SOD in group 11 at T2-T4 time points significantly rised （P〈0.05）. Conclusions SGB reduced the injury of lung tissue in rabbits with mechanical ventilation and had a protective effect to lung.

关 键 词：星状神经节阻滞 呼吸机相关性肺损伤 兔 

分 类 号：R614[医药卫生—麻醉学]