体外循环期间经肺动脉灌注肺保护液对犬肺形态及功能的保护作用

Protective effect of pulmonary artery perfusion with lung-protective solution on lung morphous and function of dogs during cardiopulmonary bypass

目的:探讨体外循环期间经肺动脉灌注肺保护液及氧合机器血对犬肺形态及功能的保护效果。方法:将18只杂种犬随机分为对照组、氧合血组(B组)及保护液组(P组)(每组6只)。体外循环(CPB)期间氧合血组及保护液组分别经肺动脉灌注氧合机器血和肺保护液,CPB前及停止后15及60min,监测气道峰压、肺血管阻力和肺静脉血氧分压,留取血标本做生化分析,对肺组织进行光、电镜观察。结果:氧合血组CPB后15和60min气道阻力均明显高于CPB前(P<0.05),且低于对照组相应时间点(P<0.05)。各组CPB后15和60min肺血管阻力均明显高于CPB前(P<0.01),肺保护液组CPB后15和60min肺血管阻力明显低于氧合血组及对照组(P<0.05)。各组CPB后15和60min氧指数均明显高于CPB前(P<0.01),肺保护液组CPB后15和60min氧指数明显高于氧合血组及对照组(P<0.05)。肺保护液组CPB后60min肺泡-动脉氧压力差(P[A-a]O2)明显低于氧合血组及对照组(P<0.001)。肺保护液组肺组织MDA含量及支气管肺泡灌洗液(PAL)中性粒细胞计数明显低于氧合血组(P<0.05)及对照组(P<0.001,P<0.05),且氧合血组低于对照组(P<0.01,P<0.05)。肺保护液组组织学改变明显轻于氧合血组(P<0.05)及对照组(P<0.001),且氧合血组明显轻于对照组(P<0.001)。结论:CPB后肺脏形态和功能有明显变化,肺动脉灌注低温肺保护液对犬肺形态和功能有良好保护作用。

Objective To explore the protective effect of pulmonary artery perfusion with lung-protective solution and oxygenated blood on lung morphous and function of dogs during cardiopulmonary bypass (CPB).Methods Eighteen adult mongrel dogs were randomly divided into three groups.During CPB,the lungs of the dogs in first group were perfused with diluted oxygenated blood from CPB-machine(group B),the lungs of the dogs in second group were perfused with cold lung-protective solution (group P),the lungs of the dogs i...