肺灌洗及外源性肺表面活性物质治疗烟雾吸入所致肺组织细胞损害

THE TREATMENT OF SMOKE INHALATION INJURY WITH LUNG LAVAGE AND EXOGENOUS PULMONARY SURFACTANT

烟雾吸入致肺组织细胞损伤后５ｍｉｎ，行肺灌洗机械通气（ＭＶ）４ｈ，观察２４ｈ。结果表明，烟雾吸入组伤后发生呼吸衰竭，肺水肿及肺部急性炎症反应，支气管肺泡灌洗液（ＢＡＬＦ）中乳酸脱氢酶、碱性磷酸酶、血管紧张素转换酶和胎盘型碱性磷酸酶水平均明显升高，肺泡壁纤维成分含量显著减少。烟雾＋灌洗＋肺表面活性物质（ＰＳ）＋ＭＶ组血气、ＢＡＬＦ中各酶水平及肺泡壁纤维成分含量较烟雾吸入组明显改善，肺部炎症、水肿等显著减轻。烟雾＋灌洗＋ＭＶ组也有一定疗效。说明早期肺灌洗和外源性ＰＳ治疗能明显保护烟雾吸入所致肺组织细胞损害，减轻炎症反应和肺水肿，改善肺功能，防止呼吸衰竭。

The lungs were lavaged with 30 ml/kg 0 9% NaCl containing 100 mg/kg PS(Fei Huo Tong)or same volume of saline via tracheal catheter at 5 min after smoke inhalation,then the animals were placed on a ventilator for 4 h,and observed until 24h postinjury.The animals in smok inhalation group showed respiratory failure,serious pulmonary edema and acute inflammatory reaction in lungs.The levels of lactate dehydrogenase,alkaline phosphatase,angiotensin convering enzyme,and the content of placental alkaline phosphatase in bronchoalveolar lavage fluid (BALF) increased,the fiber contents of alveolar walls decreased dramatically.In smok+lavage+pulmaonary surfactant+mechanical ventilation group,the arterial blood gases,all levels of the enzymes in BALF,and the fiber contents of alveolar walls were significantly improved.The inflammatory reaction and edema in lungs were alleviated markedly .In group Ⅳ,there were also effectiveness to a certain degree.Treatment with lung lavage and exogenous surfactant in early stage after smoke inhalation injury,protects effectively the lung tissues and cells from damage,suppresses the severity of inflammatory reaction and pulmonary edema,improves lung function,and prevents respiratory failure.