膈肌起搏联合机械通气对油酸兔急性呼吸窘迫综合征血流动力学、氧动力学及血气影响

The Effect of Diaphragm Pace-making Combine With Mechanical Ventilation for Haemodynamics, Oxygen Dynamics and Blood Gas of Oleic Acid Acute Respiratory Destress Syndrome

目的通过膈肌起搏联合机械通气观察对油酸型兔急性呼吸窘迫综合征血流动力学和氧动力学影响。方法选取健康成年家兔20只,耳缘静脉注射油酸法制备兔ARDS模型,行气管切开机械通气,采用自身前后对照法,作为对照组(单纯机械通气组),实验组为膈肌起搏联合机械通气组。使用Swan-Ganz导管及相关仪器观察两组血流动力学、血气分析等变化。结果与对照组比较,实验组HR、PaO_2、OI对比,P>0.05,差异不具有统计学意义,MAP、CVP、MPAP、PAWP、CO在实验组对比,P<0.05,差异具有统计学意义。结论膈肌起搏联合机械通气可以增加心脏前负荷,增加心排血量,提高平均动脉压,改善灌注,从而降低机械通气对血流动力学的副作用。

Objective To observe the effect of diaphragm pace-making combine with mechanical ventilation for haemodynamics, oxygen dynamics and blood gas of oleic acid acute respiratory destress syndrome.Methods Selected experimental animals 20 healthy adult rabbits, ear vein injection of oleic acid were prepared rabbit ARDS model, tracheotomy mechanical ventilation, the use of self controlled method, namely the control group was simply mechanical ventilation group, the experimental group diaphragm pacing joint mechanical ventilation group. Swan-Ganz catheters and related equipment were observed hemodynamics, blood gas analyzed and other changes.Results Compared with the control group and experimental group with HR, PaO2, OI, P, 0.05, was no difference had statistically significance, compared with the experimental group HR, PaO2, OI, MAP, CVP, MPAP, PAWP, CO,P＜0.05, was difference had statistically significance. Conclusion Positive pressure ventilation combined with diaphragm pacing can decrease the pulmonary circulation resistance, intrathoracic pressure, increase the cardiac output, improve perfusion and reduce side effects, to reduce side effect of mechanical ventilation for hemodynamic.