腹腔喷射通气对家猪腹膜氧合的影响

Effects of peritoneal jet ventilation on peritoneal oxygenation in pigs

目的评价腹腔喷射通气对家猪腹膜氧合的影响。方法健康家猪24只，雌雄不拘，12—16周龄，体重35～45k，采用随机数字表法，将其随机分为3组（n=8）：假手术组（s组）、腹腔常频通气组（N组）及腹腔高频通气组（H组）。麻醉诱导后经口行气管插管，机械通气，于气道机械通气35min时进行腹腔喷射通气，驱动压0．5kg／cm2，纯氧流量1．8L／min，吸呼比1．0：1．5，N组和H组通气频率分别为16和150次／min，腹腔通气期间每隔30s采集动脉血样，进行血气分析，当脉搏血氧饱和度≤90％时停止腹腔通气。记录无通气安全时间（腹腔通气开始至PaO2〈60mmHg的时间）。结果与S组和N组比较，H组PaO2升高，无通气安全时间延长（P〈0．05），3组间PaCO2差异无统计学意义（P〉0．05）。结论腹腔高频喷射通气可提高家猪腹膜氧合的效果，且可延长无通气安全时间，而腹腔常频喷射通气对家猪腹膜氧合无影响。

Objective To evaluate the effects of peritoneal jet ventilation on peritoneal oxygenation in pigs. Methods Twenty-four pigs of both sexes （12-16 weeks, 35-45 kg） were randomly divided into 3 groups （n = 8 each）： sham operation group （group S）; peritoneal regular frequency jet ventilation group （16 bpm） （group N） and peritoneal high-frequency jet ventilation group （150 bpm） （group H） . Oral tracheal intubation was performed. The animals were mechanically ventilated （VT 8-12 ml/kg, RR 12-16 bpm, I：E 1.0：1.5, FiO2 100% ） via airway. Endotracheal tubes were inserted into abdomen through the incisions in the left lower （for per- itoneal jet ventilation） and fight upper quadrant （for outlet of air）. Arterial blood PaO2 and PaCO2 were measured before （baseline） and at 30, 60, 90, 120, 150, 180, 210 and 240 s of peritoneal jet ventilation. Peritoneal jet ventilation was started after the lungs being mechanically ventilated for 35 min. Peritoneal jet ventilation was termi- nated when SpO2＂ dropped to SpO2 〈 90 % . The duration of safe apnea （ DSA, from the moment of begging of perito- neal jet ventilation to the time when PaO2 〈 60 mm Hg） . Results PaO2 was significantly higher and DSA longer in group H than in groups S and N. But there was no significant difference in PaCO2 among the 3 groups. Conclusion Peritoneal high-frequency jet ventilation can significantly enhance the efficiency of peritoneal oxygenation and prolong DSA, while peritoneal regular frequency jet ventilation has no effect on peritoneal oxygenation.