肺保护性通气治疗胸腔海水致急性肺损伤的实验研究

发布时间：2018-02-09 10:47

本文关键词： 急性肺损伤海水肺保护性通气　出处：《第二军医大学学报》2005年12期 　论文类型：期刊论文

【摘要】：目的:观察肺保护性通气治疗胸腔海水致急性肺损伤(ALI)的疗效。方法:健康杂交犬18只,锐器致开放性气胸后胸腔内注入海水(35 mg/kg)制备ALI动物模型,随机分为3组。未救治组犬未实施任何救治措施;普通救治组给以鼻导管吸氧、安放胸腔闭式引流、静脉输入5%葡萄糖等;肺保护性机械通气救治组给以机械通气、安放胸腔闭式引流、静脉输入5%葡萄糖等。动态观察动脉血气(PaO2、PaCO2、PaO2/FiO2)、血流动力学(心率、平均动脉压、心输出量)、外周血炎症介质(TNF-αI、L-6I、L-8)的变化。结果:犬致伤后PaO2显著降低,PaO2/FiO2300,外周血炎症介质水平明显升高。机械通气救治组PaO2、PaO2/FiO2、TNF-α水平显著高于普通救治组(P0.05),机械通气救治组血流动力学指标与普通救治组无显著差异。结论:应用肺保护性机械通气治疗胸腔海水导致的ALI,能有效纠正低氧血症、改善氧合。
[Abstract]:Objective: to observe the efficacy of lung protective ventilation in the treatment of acute lung injury induced by thoracic seawater. Methods: ALI animal model was established in 18 healthy crossbred dogs, 35 mg / kg seawater was injected into the thoracic cavity after acute pneumothorax induced by sharp instrument. The dogs were randomly divided into three groups. The dogs in the untreated group were given nasal catheter oxygen inhalation, closed thoracic drainage, venous infusion of 5% glucose, and the lung protective mechanical ventilation group was given mechanical ventilation. Thoracic closed drainage, venous infusion of 5% glucose, etc. Dynamic observation of arterial blood gas, Paco _ 2, Paco _ 2 / Pao _ 2 / FiO _ 2, hemodynamics (heart rate, mean arterial pressure, etc.). Results: after injury, PaO2 significantly decreased PaO2 / FiO2300, and increased the level of inflammatory mediators in peripheral blood. The level of Pao _ 2 / Pao _ 2 / FiO _ 2 / TNF- 伪 in mechanical ventilation treatment group was significantly higher than that in general treatment group (P 0.05), and the level of TNF- 伪 in mechanical ventilation treatment group was significantly higher than that in normal treatment group (P < 0.05). Conclusion: pulmonary protective mechanical ventilation for ALI induced by thoracic seawater can effectively correct hypoxemia. Improve oxygenation.
【作者单位】：海军总医院呼吸内科海军总医院呼吸内科海军总医院呼吸内科海军总医院呼吸内科海军总医院呼吸内科
【分类号】：R82

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