不同吸痰方式对ARDS犬肺内气体交换影响的实验研究

An experimental study on the effect of different endotracheal suctions on the gas exchange in ARDS dog lung

目的研究开放式气管内吸痰(OS)和密闭式气管内吸痰(CS)对急性呼吸窘迫综合征(ARDS)犬肺内气体交换的影响,选择更适宜ARDS犬气管内吸痰的方式。方法采用静脉注射油酸制备16只犬ARDS模型,每只犬随机选择使用OS和CS两种吸痰方式,于吸痰前后抽取动脉血和混合静脉血进行血气分析。结果OS后,犬动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、氧合指数(PaO2/FiO2)明显降低,肺泡-动脉血氧分压差(PA-aO2)明显增大(P<0.05);CS前后PaO2、SaO2等指标变化无显著性差异(P>0.05)。结论OS加重ARDS犬低氧血症;CS对ARDS犬肺内气体交换影响小,ARDS犬吸痰时选择CS方式更适宜和安全。

Objective To assess the effect of open endotracheal suctioning (OS) and closed endotracheal suctioning (CS) on the gas exchange in ARDS dog lung and find the better way of endotracheal suction. Methods Tracheal intubated mongre l dogs were injured by injecting oleic acid to create ARDS models. Both OS and C S were performed on each dog in randomized order. The data of blood gas were obt ained by drawing and examining the arterial and venous blood before and after su ction. Results After performing OS, there were obvious decreases in arterial ox ygen partial pressure (PaO2), arterial oxygenation (SaO2) and arterial oxygenati on partial pressure/ fractional inspired oxygen (PaO2/FiO2). Meanwhile, the alve olar-arterial oxygen partial pressure difference (PA-aO2) became significantly l arge (P<0.05). However, there were not significant differences in the indexes of PaO2 and SaO2 between before CS and after CS (P>0.05). Conclusion The OS can c ause deterioration of hypoxemia. CS is comparatively safer and more comfortable for ARDS dogs.