腹膜腔纯氧通气改善肺控制性低通气家兔的低氧血症

Peritoneal Ventilation with Pure Oxygen Improves Hypoxaemia of Rabbits Induced By Mechanical Controlled Hypoventilation

目的对控制低通气造成的低氧血症伴高碳酸血症家兔,用纯氧进行腹膜腔通气,观察其对动脉血气的影响。方法16只家兔经气管切开并插入气管导管,连接呼吸机。调整呼吸机参数,同时使用肌肉松弛剂抑制自主呼吸,造成低通气,致使兔PaO2降低和PaCO2升高,制备低氧血症伴高碳酸血症家兔模型,然后用纯氧进行腹膜腔内通气,检测腹膜腔内通气开始后0.5、1、1.5及2h动脉血气。结果经纯氧腹膜腔内通气后,PaO2由通气前的(52.50±3.46)mmHg分别显著升至腹膜腔通气后30min的(76.46±7.79)mmHg、1h的(79.62±9.53)mmHg、1.5h的(78.54±7.18)mmHg、2h的(81.1±8.3)mmHg(P均<0.05),通气各时点之间差异无统计学意义(P>0.05)。而PaCO2变化不显著(P>0.05),由(63.84±9.09)mmHg降至腹膜腔通气后0.5h的(59.84±14.22)mmHg、1h的(59.16±15.5)mmHg、1.5h的(60.02±7.07)mmHg、2h的(61.38±6.56)mmHg。结论用纯氧进行腹膜腔内通气能明显改善肺控制性低通气家兔的低氧血症,而对高碳酸血症改善不明显。

Objective To observe the effects of peritoneal ventilation with pure oxygen in the rabbits with hypoxaemia and hypercapnia induced by mechanical controlled hypoventilation. Methods Sixteen rabbits were invasively ventilated after trachea incision. Hypoxaemia and hypercapnia were induced by hypoventilation which was implemented both by degrading ventilation parameters and respiratory depression induced by intravenous infusion of muscle relaxant. Then pure oxygen was insufflated into the peritoneal cavity and arterial blood gases were measured every 30 minutes for two hours. Results The PaO2 was （52. 50±3.46） mm Hg at baseline and increased to （76.46 ± 7. 79 ） mm Hg, （79. 62 ±9. 53 ）mm Hg, （78.54± 7. 18 ） mm Hg, and （ 81.1± 8. 3 ） mm Hg, respectively at 30,60,90, and 120 minutes after the peritoneal ventilation with pure oxgen （ all P 〈 0. 05 ）. Meanwhile PaCO2 was （ 63.84 ±9.09 ） mm Hg at baseline and （59. 84± 14. 22 ） mm Hg, （ 59. 16 ±15.5 ） mm Hg, （ 60. 02 ±7.07 ） mm Hg, and （ 61.38 ± 6. 56）mm Hg, respectively at 30,60,90, and 120 minutes after the peritoneal ventilation with pure oxgen with no significant change （P 〉 0. 05 ）. Conclusion Peritoneal ventilation can obviously improve hypoxaemia induced by mechanical controlled hypoventilation, whereas hypercapnia remains unchanged.