海水淹溺性肺损伤机制的研究进展

Mechanism of seawater drowing-induced lung injury:research progress

溺水是一个重要的公共卫生安全问题,是最常见的意外死亡原因之一。肺是溺水后受损的主要器官之一,海水或者淡水吸入后会直接损伤肺组织,同时诱发氧化应激和炎症反应,进一步加重肺损伤,近1/3的患者最终进展为急性呼吸窘迫综合征。肺泡表面活性物质被破坏、肺泡上皮结构和功能改变及肺毛细血管通透性增加等病理改变的综合作用,可导致肺顺应性降低、肺内分流增加、肺不张和肺水肿。海水是一种低温高渗液体,且含有大量细菌,会在肺和肺泡内产生更为强烈的损伤性刺激,因此海水淹溺诱发的急性呼吸窘迫综合征病程进展更迅速,机制更复杂。本文对海水淹溺性肺损伤相关机制的研究进展进行了综述,以期为其治疗提供新思路。

Drowning is an important public health safety issue and is one of the most common causes of accidental death.Lungs are one of the main organs damaged after drowning.Inhalation of seawater or freshwater will directly damage lung tissue,and induce oxidative stress and inflammatory responses to further aggravate lung damage.Nearly 1/3 of patients eventually progress to acute respiratory distress syndrome.The combined effect of pathological changes such as alveolar surfactant disruption,altered alveolar epithelial structure and function and increased pulmonary capillary permeability ultimately leads to decreased lung compliance,increased intrapulmonary shunt,atelectasis and pulmonary edema.However,because seawater is a hypothermic and hypertonic liquid and contains a large number of bacteria,it produces more intense damaging stimulation in the lungs and alveoli.Therefore,the course of acute respiratory distress syndrome induced by seawater drowning is more rapid and the mechanism is more complex.This article reviews the research progress on the mechanism of seawater drowning-induced lung injury in order to provide new ideas for its treatment.