高频通气对海水淹溺肺水肿肺弥散功能的影响

Effect of High Frequency Jet Ventilation on Pulmonary Diffusion Function in Pulmonary Edema after Seawater Drowning

对海水淹溺肺水肿（PE－SWD）进行高频喷射通气（HFJV）治疗，观察和分析了HFJV对PE－SWD肺弥散功能的影响，探讨HFJV的治疗机制。应用血气酸碱分析仪和计算机图像分析系统，对兔动脉血气酸碱6项指标和肺毛细血管内皮细胞Na+－K+－ATPase9项参数进行自动检测和定量测量。结果表明：HFJV－GPaO_2、血氧饱和应（SO_2）、pH、实际碳酸氢盐（AB）、碱剩余（BE）和肺毛细血管内皮细胞Na+－K+－ATPase活性均比PE-SWD-G明显升高（P＜0.01或P＜0.05）。但每项指标均未能恢复到淮海水前的正常水平。PaCO_2在两组之间无显著性差异。作者认为，HFJV可较好地增加PE-SWD肺泡弥散面积、减少弥散膜的厚度、调整VA／Q比例失调、改善肺的弥散功能。若与其它救治措施综合应用，可望获得更好的疗效。

Pulmonary edema after seawater drowning (PE-SWD) was treated by highfrquency jet ventilation(HFJV). The effect of HFJV on pulmonary diffusion function in PE-SWDwas observed and analysed, and treatment mechanism of HFJV was also studied. Six indexes ofblood-gas and acid-base and 9 parameters of Na+ -K+ -ATPase in the endothelial cells of the lungcapillaries were observed and measured by a blood-gas analyser and computer image analyser sys-tem; The results showed that PaO2, oxygen saturation (SO2 ), pH, actual bicarbonate (AB), baseexcess(BE) and Na+ -K+ -ATPase activity in the endothelial cells of the lung capillaries in HFJVgroup were much higher than in PE-SWD group(P < 0. 01 or P < 0. 05 ). But the 6 indexes men-tioned above didn' t return to normal levels. There was no significant difference in PaCo2 betweenPE-SWD group and HFJV group. The authors conclude that HFJV treatment may increase thediffusion area of alveoli, decrease the thickness of diffusion membrane, correct VA/Q imbalanceand improve pulmonary diffusion function. Combined with other treatment measures, the HFJVcan lead to better therapeutic results.