部分液体通气与常规机械通气治疗兔海水型肺水肿的比较  

Experimental study of partial liquid ventilation in rabbits with pulmonary edema of seawater drowning

作　　者：段蕴铀[1] 张新红[1] 冯华松[1] 胡慧军[1] 赖莉芬[1] 段玮[2] 宁浩勇[2] 

机构地区：[1]海军总医院呼吸科,北京100037 [2]海军总医院病理科,北京100037

出　　处：《中国急救医学》2004年第4期261-264,共4页Chinese Journal of Critical Care Medicine

基　　金：海军科研基金资助项目 (No 0 0 -3 3 2 2 )

摘　　要：目的　观察部分液体通气 (PLV)对海水淹溺型肺水肿 (PE -SWD)家兔肺内气体交换、肺顺应性、气道峰压、体循环功能及肺损伤程度的影响 ,并与常规机械通气 (CMV)进行比较。方法　健康成年雄性新西兰兔 2 4只 ,经气管插管注入海水制备成PE -SWD模型后 ,随机分为 3组 (各组n =8) ,阳性对照组 (PE) ;常规机械通气组 (CMV) ,即CMV +呼气末正压(PEEP)治疗 ;部分液体通气组 (PLV) ,即肺内注入全氟萘烷 (FDC) +CMV +PEEP。治疗 180min ,分别观察各组治疗前后动脉血气、呼吸力学、体循环参数、肺病理组织学和肿瘤坏死因子 (TNFα)的变化。结果　PLV可明显改善PE -SWD家兔的动脉血气 ,并能提高肺顺应性 ,降低气道峰压 ,减少肺组织损伤 ,对体循环无明显影响。Objective To observe the effect of partial liquid ventilation(PLV) on gas exchange,pulmonary compliance,blood dynamics in the pulmonary edema rabbits after seawater drowning.Methods 24 healthy male new Zealand rabbits were randomly divided into three groups (n=8).Every group was treated with various methods after PE-SWD model was made.They are as follows:PE group with no treatment,CMV group with conventional mechanical ventilation and PEEP,PLV group with CMV,PEEP and FDC.All the rabbits were treated for 3 hours.Blood gases,pulmonary mechanics,hemodynamics,pulmonary histopathology and TNF-α were observed during the experiment.Results In PLV group,PaO 2 increased obviously,airway pressure decreased,pulmonary dynamic compliance increased and pulmonary injury reduced.There was no significant changes in HR and MAP after treatment compared with PE group.Conclusion Pulmonary gas exchange and compliance improved significantly during PLV in the PE-SWD rabbits without obvious influence on hemodynamic status.

关 键 词：部分液体通气 全氟碳化合物 海水淹溺型肺水肿 兔 

分 类 号：R563.8[医药卫生—呼吸系统]