全氟化碳对兔急性肺损伤的治疗作用及影像学表现

Treatment by perfluorocarbon and CT features in acute lung injury in rabbits

目的观察部分液体通气对油酸型兔急性肺损伤的治疗作用及肺部CT影像的变化。方法16只健康成年大白兔经油酸致伤后随机分为2组,常规机械通气组和部分液体通气组各8只,于各观察时相点检测动脉血气、肺静态顺应性,并于治疗前后行肺部CT扫描。结果PLV组动脉血氧分压从(109±22)mm Hg升高到(194±38)mm Hg(P<0.05),动脉血二氧化碳分压从(53±7)mmHg降低到(45±7)mmHg(P<0.05),肺静态顺应性从(1.3±0.3)ml/cmH2O升高到(1.7±0.3)ml/cm H2O(P<0.05),血气指标及肺顺应性的改善均优于常规机械通气组。CT显示油酸型兔急性肺损伤兔肺组织呈现明显的重力依赖性分布,加入的全氟化碳主要分布在肺的重力依赖区。结论部分液体通气治疗急性肺损伤时,全氟化碳在肺内的分布是不均一的,主要分布于肺的重力依赖区,与肺的损伤部位一致,有利于发挥治疗作用。

Objective To observe the therapeutical effect of partial liquid ventilation（PLV） with perfluorocarbon（PFC） and CT features in oleic acid-induced acute lung injury in rabbits.Methods A total of 16 healthy white rabbits were randomly allocated into two groups and treated with various methods after establishment of OA acute lung injury model.Rabbits in the control group were treated by conventional mechanical ventilation and those in the treatment group were treated by partial liquid ventilation with perfluorocarbon.The parameters such as PaO2,PaCO2,Csta,were observed at 0,1,2,3,and 4 h before and after treatment.CT scan of the rabbit lungs was performed before and after perfusion of perfluorocarbon.Results In PLV group,PaO2 increased from（109±22） mm Hg to（194±38） mm Hg（P0.05）,but PaCO2 decreased from（53±7） mm Hg to（45±6） mm Hg（P0.05）,and Cst increased from（1.3±0.3） ml/cm H2O to（1.7±0.3） ml/cm H2O（P0.05）.CT scan showed the distribution in the lung injury region was in a gravity-dependent manner,and the added PFC was distributed predominantly in these regions.Conclusion Perfluorocarbon is distributed predominantly in the lungs in a gravity-dependent manner,comforming with the injury region,which can be beneficial to the therapeutical effect.