肺损伤模型中压力与容量通气模式的比较

发布时间：2018-03-30 23:07

本文选题：急性肺损伤　切入点：压力支持通气　出处：《上海交通大学学报(医学版)》2015年09期

【摘要】：目的确定压力支持通气(PSV)对实验性肺损伤的长期作用。方法 20只健康雌兔通过反复灌洗建立急性肺损伤的动物模型。将实验动物随机分成两组(n=10):PSV组将压力水平设在维持潮气量4 m L/kg,呼吸频率40/min;控制通气(CMV)组,潮气量为10 m L/kg,呼吸频率为20/min;两组呼气末正压均设为10 cm H2O。在急性肺损伤发生即刻及发生后2、4、8和12 h分别进行血气分析和通气-血流(VA/Q)分布的测定。结果在PSV组,由于肺内分流的减少和VA/Q比正常的区域面积增加,氧合明显改善。CMV组与PSV组相比,肺内分流显著降低(P0.05)。结论在急性肺损伤动物模型中,PSV通过减少VA/Q比值的失衡明显改善气体交换,然而在改善VA/Q分布方面,CMV比PSV更为有效。
[Abstract]:Objective to determine the long-term effect of pressure support ventilation (PSV) on experimental lung injury.Methods the animal model of acute lung injury was established in 20 healthy female rabbits by repeated lavage.The experimental animals were randomly divided into two groups: the pressure level was 4 mL / kg and the respiratory rate was 40 min in the PSV group, and the tidal volume was 10 mL / kg and the respiratory rate was 20% min in the control group. The positive end-expiratory pressure was 10 cm H _ 2O in both groups.Blood gas analysis and VAA / Q distribution were measured at the time of acute lung injury and 2 h and 12 h after the injury, respectively.Results in the PSV group, the pulmonary shunt decreased significantly because of the decrease of the intrapulmonary shunt and the increase of the area of VA/Q compared with the normal area, and the improvement of oxygenation. Compared with the PSV group, the pulmonary shunt decreased significantly (P 0.05).Conclusion in animal models of acute lung injury, VA/Q can significantly improve gas exchange by reducing the imbalance of VA/Q ratio, but it is more effective than PSV in improving the distribution of VA/Q.
【作者单位】：广东药学院附属第一医院麻醉科;
【基金】：广东省医学科学技术研究基金(A2013330)~~
【分类号】：R563.8;R-332

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