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/FiO2<300,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(P<0.05),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。
Objective：To observe the therapeutic effects of lung protective ventilation on acute lung injury caused by chest trauma and seawater. Methods： Acute lung injury was induced in 18 healthy dogs by open pneumothorax and seawater and the dogs were then randomly divided into 3 groups： non-treatment group（received no treatment）, common treatment group （nasal ventilation, thoracic drianage and intravenous 5%o glucose solution） and lung protective ventilation group （mechanical ventilation, thoracic drianage and intravenous 5% glucose solution） . Blood samples were taken at different time points to observe the changes of blood gas （PaO2 ,PaCO2and PaO2/FiO2 ）, hemodynamic parameters （heart rate, mean blood pressure, cardiac output） and cytokines（TNF-α, IL-4 and IL-8）. Results： After injury, PaO2 declined significantly in the dogs, PaO2/FiO2 was lower than 300 and the levels of TNF-α, IL-6 and IL-8 were increased obviously. PaO2 ,PaO2/FiO2 and TNF-α level were significantly higher in lung protective ventilation group than those in common treatment group（P〈0.05）, and their hemodynamic parameters were similar. Conclusion： Lung protective ventilation is effective to improve oxygen partial pressure and oxygenation index in acute lung injury dogs caused by chest trauma and seawater.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2005年第12期1358-1360,共3页
Academic Journal of Second Military Medical University
关键词
急性肺损伤
海水
肺保护性通气
acute lung injury
seawater
lung protective ventilation
