比例辅助通气治疗幼兔胎粪吸入的肺组织病理观察

Observation of the lung pathology of meconium aspirated rabbits treated by proportional assist ventilation

目的观察比例辅助通气(PAV)治疗幼兔胎粪吸入的肺组织病理变化。方法将30只日龄20～30d的幼兔随机分为灌入胎粪后实施比例辅助通气组(PAV组)、灌入胎粪后实施同步间歇指令通气组(SIMV组)、灌入胎粪后不予通气组(MAS对照组)以及灌生理盐水不予通气组(空白对照组),各组分别于灌后8h处死。观察湿干重比及病理大体评分,光镜下观察肺损伤程度。结果 (1)四组间肺组织湿干重比的比较,差异有统计学意义(F=47.900,P=0.000),PAV组湿干比较MAS组低,差异有统计学意义(P<0.05);PAV组湿干重比较SIMV组低,差异有统计学意义(P<0.05);SIMV组与MAS组湿干重比较,差异无统计学意义(P=0.895);(2)四组之间肺损伤病理评分比较,差异有统计学意义(F=118.125,P<0.05)。SIMV组与MAS组肺损伤病理评分比较,差异无统计学意义(P=0.093),PAV组评分较SIMV组低,差异有统计学意义(P<0.05),PAV组评分较MAS组低,差异有统计学意义(P<0.05)。结论兔胎粪吸入机械通气治疗应用PAV时所致的肺损伤程度较应用SIMV时小。

Objective To observe the lung pathology of meconium aspirated rabbits treated by proporation assist ventilation.Methods The 20-30 days rabbits were randomly divided into four groups:implement proportional assist ventilation after poured into the meconium (PAV group),implement synchronized intermittent mandatory ventilation after meconium instillation (SIMV group),no ventilation after meconium instillation (MAS group)and the saline irrigation with no ventilation group (control group).Each group were sacrificed after 8 hours,lungs and tranchea were excised,then observed the ratio of wet to dry weight (W/D)and pathological score,and lung injury in moderate.Results (1)Among the four groups,there are statistically significant differences in the ratio of wet to dry weight(F=47.900,P=0.000),The PAV group was significantly lower than that of the MAS group(P<0.05).The PAV group was significantly lower than that of the SIMV group(P<0.05).There was no statistically significant difference between the SIMV group and the MAS group(P>0.05).(2)Among the four groups,there are statistically significant differences in the scores of lung injury(F=118.125,P<0.05).There was no statistically significant difference between the SIMV group and the MAS group(P>0.05).The scores of lung injury in PAV group was significantly lower than that of the MAS group(P<0.05).The scores of lung injury in PAV group was significantly lower than that of the SIMV group(P<0.05).Conclusions Application of proportional assisted ventilation on rabbits makes minor lung injury compared with application SIMV.