家猪腹腔不同频率喷射通气腹膜氧合效果及安全性的比较

Effects of different frequencies of intro-peritoneal jet ventilation on peritoneal oxygenation and safety in pigs

目的比较不同频率腹腔喷射通气（IPJV）后家猪腹膜氧合的效果及安全性。方法36只健康家猪随机分为对照组（c组）、实验组（F1、F2、R、F4及F5组），每组6只。待家猪经口腔行气管插管后生命体征平稳10min后，以5L／min的氧流量充分吸氧去氮5min，夹闭气管导管同时予以IPJV（此时记为T0），C组腹腔导管开放无通气，五个实验组的通气频率依次为20、40、80、120及160次／分。每隔30秒行血气分析，直至SaO2≤90％时最后行血气分析，同时停止IPJV并恢复经气道给氧。监测记录无通气安全时限（DSA）。结果F2、R、R及R组的DSA明显长于C组（P〈0．05）；R、F4及F5组DSA明显长于F1组（P〈0．05）；R组及F4组DSA明显长于F2组及F5组（P〈0．05）。结论IPJV（80-120次／分）可在保证血流动力学稳定的前提下有效提高家猪腹膜氧合效果并延长DSA。

Objective To assess the effects of different frequencies of intro-peritoneal jet ventilation （IPJV） on peritoneal oxygenation and safety in pigs. Methods Thirty-six pigs were divided into six groups （n = 6）： groups C, F1, F2, F3, F4 and F5. All pigs received general anesthesia and endotracheal intubation. Ten minutes after achieving hemodynamic stability, all pigs were ventilated with 100% oxygen at a flow rate of 5 L/min for 5 minutes to remove the nitrogen in the lung. Two tubes were placed in the thoracic cavity for the inflow and outflow of IPJV. The start of peritoneal ventilation was noted as To. Pigs in groups F1, F2, F3, F4 and group F5 were ventilated with 100% oxygen at a rate of 20, 40, 80, 120 and 160 times per minute respectively, while no treatment was applied to those in group C. For all the groups, arterial blood gas values were monitored every 30 seconds until the oxygen saturation （SaO2） descended to less than 900//00. The duration of safe apnea （DSA, time recorded from To to the time when PaO2 decreased to less than 60 mm Hg）, MAP, CVP, HR and intro-abdominal pressure （IAP） were recorded throughout the experiments. Results Compared with group C, DSA in groups F2, F3, F4 and F~ were significantly longer （P〈0.05）. The DSA in groups F3, F4 and group Fs were significantly longer than that in group F1 （P〈0.05）. DSA in the group F3 and F4 were significantly longer than that in groups F2 and F5 （P〈0. 05）. Conclusion With stable hemodynamics, the IPJV with a frequency between 80 and 120 times per minute can provide favorable peritoneal oxygenation and prolong DSA in the pigs.