纯氧气腹对兔海水淹溺型肺损伤氧合水平的影响  

Effects of pure oxygen pneumoperitoneum on early oxygenation in rabbits with seawater drowning-induced lung injury

作　　者：陈林碧 莫云长[1] 王均炉[1] Chen Linbi;Mo Yunchang;Wang Junlu(Department of Anesthesiology,First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第一医院麻醉科,325000

出　　处：《中国药物与临床》2022年第6期489-493,共5页Chinese Remedies & Clinics

基　　金：国家自然科学基金(81603685)。

摘　　要：目的探讨纯氧气腹对兔海水淹溺型肺损伤(SW-ALI)早期氧合水平的影响。方法建立兔SW-ALI模型,24只日本大耳白兔采用随机数字表法分为对照组、模型组和氧气组。对照组只进行手术操作而不进行海水灌注;模型组和氧气组均在手术操作稳定后经灌注导管进行海水灌注,在海水灌注结束后分别立即建立氮气气腹和纯氧气腹。3组实验动物分别于手术操作后及海水灌注后0 min、5 min、15 min、30 min以及60 min行动脉血气分析检测血氧饱和度(SO_(2))、动脉氧分压(PaO_(2))以及动脉二氧化碳分压(PaCO_(2));分别于海水灌注后60 min取肺组织行形态学观察和肺干/湿(D/W)比值测定;于海水灌注后60min取海马组织行苏木精伊红染色(HE)染色和尼氏染色。结果模型组在海水灌注后0 min、5 min、15 min、30 min SO_(2)较对照组显著下降,0 min为(60.1±15.7)%和(93.0±2.8)%,5 min为(43.4±17.6)%和(94.5±2.1)%,P<0.01,15min为(66.7±11.6)%和(96.0±1.4)%,30 min为(74.3±10.1)%和(96.5±2.1)%,(P均<0.05),模型组在海水灌注后0 min、5 min、15 min、30 min以及60 min PaO_(2)较对照组显著下降,0 min为(38±7)mmHg和(82±10)mmHg,5 min为(32±10)mmHg和(85±13)mmHg,15 min为(51±11)mmHg和(40±6)mmHg,30 min为(8±13)和(49±13)mmHg,60 min为(50±13)mmHg和(104±13)mmHg,(P均<0.05),氧气组在海水灌注后5 min SO_(2)较模型组显著升高(67.5±21.8)%和(43.4±17.6)%,P<0.05,氧气组在海水灌注后15 min PaO_(2)显著高于模型组[(51±11)mmHg和(40±6)mmHg,P<0.05];模型组和氧气组在制模后均出现明显肺损伤,肺组织形态学观察可见氧气组肺损伤程度较模型组轻,制模后60 min模型组肺组织D/W值较对照组显著降低[(0.111±0.010)比(0.210±0.020),P<0.05],在纯氧气腹作用下,氧气组肺组织D/W值较模型组显著升高[(0.161±0.030)比(0.111±0.010),P<0.05];病理学染色均提示氧气组海马神经元缺氧性损伤较模型组轻。结论纯氧气腹可以显著提高SW-ALI兔的�Objective To investigate the effect of pure oxygen pneumoperitoneum on early oxygenation in rabbits with seawater drowning-induced acute lung injury(SW-ALI).Methods SW-ALI was modeled in rabbits.A total of 24 Japanese white rabbits were randomized into the control group,model group and oxygen group.The control group underwent surgery alone,without seawater perfusion.The model group and oxygen group underwent seawater perfusion via a catheter after a stable surgical condition was reached,which was immediately followed by establishment of nitrogen pneumoperitoneum and pure oxygen pneumoperitoneum,respectively.The three groups of experimental animals were then subjected to arterial blood gas analysis for measurement of blood oxygen satura-tion(SO_(2)),arterial oxygen partial pressure(PaO_(2))and arterial carbon dioxide partial pressure(PaCO_(2))immediately after surgery and at 0,5,15,30 and 60 min after seawater perfusion.At 60 min after seawater perfusion,the lung tissue was harvested for morphological study and lung dry/wet(D/W)ratio measurement,and the hippocampal tis-sue was harvested for HE staining and Nissl staining.Results Compared with control group,the model group showed significantly lower SO_(2) at 0 min[(60.14±15.73)%vs(93.00±2.83)%,P<0.05],5 min[(43.43±17.55)%vs(94.50±2.12)%,P<0.01],15 min[(66.71±11.64)%vs(96.00±1.41)%,P<0.05]and 30min[(74.29±10.09)%vs(96.50±2.12)%,P<0.05]after seawater perfusion,as well as significantly lower PaO_(2) at 0 min[(38.00±7.46)mmHg vs(82.00±9.90)mmHg],5 min[(31.71±9.69)mmHg vs(85.00±12.73)mmHg],15 min[(51.00±10.66)mmHg vs(40.00±6.27)mmHg],30 min[(57.75±13.22)mmHg vs(48.71±13.10)mmHg]and 60 min[(50.29±13.24)mmHg vs(103.50±13.44)mmHg]after seawater perfusion(all P<0.05).Compared with the model group,the oxygen group showed significantly higher SO_(2) at 5 min[(67.50±21.82)%vs(43.43±17.55)%,P<0.05]after seawater perfusion,as well as significantly higher PaO_(2) at 15min[(51.00±10.66)mmHg vs(40.00±6.27)mmHg,P<0.05]after seawater perfusion.Both the model gr

关 键 词：气腹 人工 接近淹溺 肺损伤 

分 类 号：R649.3[医药卫生—外科学]