低血压因素对气管导管套囊诱发家兔气管粘膜损伤的影响  

Effect of hypotension factor on endotracheal tube cuff-induced damage to tracheal mucous membrane of rabbits

作　　者：吴文浩[1] 马淑贤[1] 王立宪 吴江丽 杨焱捷 孙章楠 黄立宁[1] 

机构地区：[1]河北医科大学第二医院麻醉科,石家庄市050000

出　　处：《中华麻醉学杂志》2017年第11期1402-1404,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价低血压因素对气管导管套囊诱发家兔气管粘膜损伤的影响。 方法健康家兔80只，雌雄不拘，3.0～3.5月龄，体重2.5～3.5 kg，根据气管导管套囊压和MAP两处理因素四个水平随机分为16组（n＝5）：MAP不降低时不同套囊压组（C1M1组、C2M1组、C3M1组、C4M1组）、MAP降低基础值的20%时不同套囊压组（C1M2组、C2M2组、C3M2组、C4M2组）、MAP降低基础值的30%时不同套囊压组（C1M3组、C2M3组、C3M3组、C4M3组）和MAP降低基础值的40%时不同套囊压组（C1M4组、C2M4组、C3M4组、C4M4组）。不同套囊压分别为0、10、20和30 cmH2O。气管插管2 h时，取套囊压迫区的气管制备切片，HE染色后，光镜下观察气管粘膜的病理学结果，并进行气管粘膜损伤评分。 结果在同一低血压水平（MAP降低基础值的20%、30%、40%）时，气管粘膜损伤评分随套囊压的增加而升高（P〈0.05）；在同一套囊压水平（10、20、30 cmH2O）时，气管粘膜损伤评分随MAP的降低而增加（P〈0.05）。套囊压与MAP存在交互作用，F＝2.034（P〈0.05）。 结论低血压因素和气管导管套囊因素对气管粘膜损伤的影响存在交互作用；低血压因素可加重气管导管套囊诱发家兔气管粘膜损伤。Objective To evaluate the effect of hypotension factor on endotraeheal tube cuff-in- duced damage to tracheal mucous membrane of rabbits. Methods Eighty healthy rabbits of both sexes, aged 3.0-3.5 months, weighing 2.5-3.5 kg, were divided into 16 groups （n= 5 each） according to the cuff pressure and mean arterial pressure （ MAP ） ： different cuff pressures when MAP did not decrease groups （C1Ml group, C2MI group, C3MI group, C4M1 group）, different cuff pressures when MAP de- creased by 20% of the baseline value groups （C1M2 group, C2Ma group, C3Mz group, CaM2 group） , dif- ferent cuff pressures when MAP decreased by 30% of the baseline value groups （C1M3 group, C2M3 group, C3M3 group, C4M3 group） , and different cuff pressures when MAP decreased by 40% of the baseline value groups （CIM4 group, CzM4 group, C3M4 group, C4M4 group）. Different cuff pressures were 0, 10, 20 and 30 emil20. At 2 h of tracheal intubation, the tracheas in the cuff-compressed area were harvested and sliced for examination of the pathological changes of tracheal mucous membrane after haematoxylin and eosin staining （with a light microscope） , and the damage to tracheal mucous membrane was scored. Results When at the same low pressure （ MAP decreased by 20%, 30% and 40% of the baseline value） , the score of damage to tracheal mucous membrane increased with the increasing cuff pressures （P〈0.05）. When at the same cuff pressure （10, 20 and 30 cmH20） , the score of damage to tracheal mucous membrane in- creased with the increasing MAP （P〈0.05）. There was interaction between cuff pressure and MAP, F = 2. 034 （P〈0.05）. Conclusion There is interaction between the effects of hypotension factor and endotra-cheal tube cuff factor on damage to tracheal mucous membrane; hypotension factor can aggravate endotra- cheal tube cuff-induced damage to tracheal mucous membrane of rabbits.

关 键 词：低血压 插管法 气管内 

分 类 号：R614[医药卫生—麻醉学]