高频喷射通气结合胸壁挤压对组胺致肺损伤犬呼吸循环功能的影响

Cardiorespiratory effects of high frequency jet rentila-tion combined with chest wall compression on dogswith histamine-induced lung injury

以高频喷射通气结合胸壁挤压（ＨＦＪＶ＋ＣＷＣ）为通气模式，观察其对组胺致肺损伤犬呼吸循环功能的影响，并与单纯高频喷射通气（ＨＦＪＶ）进行比较。结果表明：与ＨＦＪＶ相比，ＨＦＪＶ＋ＣＷＣ时的功能残气量（ＦＲＣ）、ＰａＣＯ＿２和ＰＣＯ＿２均显著降低（Ｐ＜０．０１），肺泡通气量（Ｖ＿Ａ）和二氧化碳排出量（ＣＯ＿２）均显著增高（Ｐ＜０．０１），每分呼出气量（Ｖ＿Ｅ）、ＰａＯ＿２、ＰＣＯ＿２、吸气峰压（ＰＩＰ）、平均气道压（Ｐａｗ）、呼气末压（ＥＥＰ）、ＨＲ、平均动脉压（ＭＡＰ）、肺动脉压（ＰＡＰ）和肺毛细血管楔压（ＰＣＷＰ）均无显著变化（Ｐ＞０．０５）。提示：ＨＦＪＶ＋ＣＷＣ除保留单纯ＨＦＪＶ时气道开放、气道低压、良好的血液氧合、不影响循环功能等特点外，还具有增加呼气动力，改善肺泡通气，显著促进ＣＯ＿２排除等优点。

Cardiorespiratory effect of high freq uency jetventilation com bined with chest wall com pression(HFJV+CWC )was compared with that of only highfrequency jet ventilation(HFJV) in dogs withhistamine-induced lung injury. The results showedthat,compared with HFJV,FRC,PaCo,and PCO_2were significantly reduced(p<0.01),V_A andVCO_2were markedly increased(P<0.01),but therewere no obvious changes in VE,PaO_2,P O_2,PIP,PaW,EEP,HR,MAP,PAP and PCWP duringHFJV+CWC (P>0.05).It is suggested thatHFJV+CWC not only has the characteristics seen inHFJV,such as opening the airway, keeping a lowairway pressure and a satisfactory oxygenation andnot compromising the hemodynamic function, butalso the advantages, such as increasing the exDiratorypower,im proving the alveolar ventilation andmarkedly enhancing CO_2 elimination.