两种机械通气方式在兔海水型肺水肿中的应用比较  

The Therapeutical Effect of Various Mechanical Ventilation on Pulmonary Edema after Seawater Drowning in Rabbits

作　　者：韩志海[1] 段蕴铀[1] 王洪武[1] 赖莉芬[1] 赵秀琴[1] 

机构地区：[1]海军总医院呼吸科,北京100037

出　　处：《海军总医院学报》2004年第1期1-6,共6页Journal of Naval General Hospital of PLA

摘　　要：目的　观察不同通气方式对海水淹溺型肺水肿的救治作用。方法　应用常规机械通气和高频喷射通气对 4 2只海水淹溺型肺水肿兔进行分组救治。不同时间点观察血气分析、呼吸动力学、血流动力学、肺损伤指标 ,并进行病理学检查和观察存活时间。结果　两种通气方式治疗后血氧分压、血氧饱和度、二氧化碳分压均较未治疗组有明显改善 (P <0 .0 1) ,呼吸动力学、血流动力学异常得到一定程度纠正 ,肿瘤坏死因子 α、肺泡灌洗液中性粒细胞计数等肺损伤指标也显示通气治疗后肺损伤情况减轻。两种通气方式之间比较显示常规机械通气较高频喷射通气治疗能更好地改善海水淹溺型肺水肿时的低氧情况。结论　常规机械通气和高频喷射通气治疗海水淹溺型肺水肿时低氧血症均取得满意效果 ,并减轻了肺损伤的程度。Objective To observe the therapeutical effect of conventional mechanical ventilation (CMV) and high frequency jet ventilation (HFJV) on pulmonary edema after seawater drowning in rabbits. Methods Forty two New Zealand rabbits with seawater lavage induced pulmonary edema were randomly assigned to receive CMV and HFJV. Blood gas analysis, pneodynamic, hemodynamics status and tumor necrosis factor (TNF-α) leuel in serum were monitored at various time point. After 3 hours vetilation, 7 rabbits of each group were killed to gain lung tissues for pathological examination and lung lavege fluid was analyzed for the count of leukocytes. Results PaO 2 and SO 2 were significantly increased after the use of ventilation in pulmonary edema rabbits models(P<0.01),especially in CMV treatment. Pneodynamics and hemodynamics were ameliorated. The results of TNF-α assay and the count of leukocytes showed that the degree of lung injury were relieved. Conclusion Our study showed CMV and HFJV could improve hypoxemia of PE-SWD rabbits significantly and relieve the degree of lung injury to some extend.

关 键 词：机械通气 肺水肿 海水 

分 类 号：R332[医药卫生—人体生理学]