气管套囊对ALI兔模型气管黏膜结构影响的研究

The effect of tracheal tuff on tracheal mucosal morphology and structure in rabbits with Bcute lung injury

目的探讨气管套囊对急性肺损伤兔气管黏膜形态结构的影响。方法健康兔144只,按气囊压力不同分为A组(气囊压力30cm H2O,气囊充气时间1、2、4、8h)、B组(气囊压力20cm H2O,气囊充气时间1、2、4、8h)、C组(气囊压力20cm H2O,每隔2、4、8h气囊放气10、20、30min)和D组(对照组)4组,分别对气管黏膜做电镜超微结构观察。结果气囊压力20cm H2O维持小于8h,上皮少量纤毛缺失,柱状上皮细胞轻度肿胀,每隔4h放气时间在20min上皮细胞层次较清晰,细胞形态基本正常。结论气囊压力20cm H2O对气管黏膜的损伤最轻;气囊充气4h后放气大于或等于20min再充气可以减轻黏膜损伤。

Objective To investigate the effect of tracheal cuff on tracheal mucosal morphology and structure in rabbits with a- cute lung injury. Methods One hundred and forty-four healthy rabbits were randomly assigned into four groups：A（pressure of air- bag： 30cm H2 O, lasting time in this pressure： 1,2,4,8h）, B （pressure of airbag： 20cm H2O, lasting time： 1,2,4,8h）, C （pressure of airbag：20cm H20,every 2,4,8h to deflate for 10,20,30min） ,D（control group）. The ultrastructure of tracheal mucosa of each ani- mal was observed under electron microscopy. Results Maintaining the pressure of 20cm H2O for less than 8h can make only a small number of epithelial cilia miss and can make columnar epithelial cells swell mildly. The epithelial cells in groups which deflate every 4h for 20 min have normal cell morphology and clear cell levels. Conclusion The airbag pressure of 20cm H2O has the least damage on tracheal mucosa. The method of maintaining the pressure for 4h and then deflating for more than 20 min can reduce the mucosal damage.