急性颅内压增高时肺动静脉分流的意义

Change of pulmonary arteriovenous shunt following intracranial hypertension in dogs

目的 探讨颅内压增高对呼吸功能的影响。方法 16条犬分为高颅压组和对照组。高颅压组升高颅内压至 8 kPa(1 kPa=7.5 mm Hg),维持 6 h。两组均行肺动脉插管,动态测量肺分流量。结果 颅内压增高后肺动脉压、肺血管阻力指数、肺泡动脉氧分压差显著增加;肺动静脉分流率(Qs/Qt)迅速从(9.70±4.83)％增加到(21.80±6.89)％(P<0.01)。呼吸抑制、肺不张、肺水肿、肺部感染、肺血流动力变化共同参与颅内压增高后的肺分流增加。结论 肺分流率是颅内压增高后呼吸功能不全的重要指标。

Objective To investigating the effect of intracranial hypertension on the respiratory function. Methods 16 dogs were divided into two groups: intracranial hypertension group (8 kPa for 6 h) and control group. Pulmonary shunt rate were measured by using Svan-Ganz technique. Results Pul- monary shunt rate was increased quickly from (9. 70 ±4. 83)% to (21. 80±6. 89)% (P < 0. 01) and correlated positively with arterial oxygen tension. Respiratory depression, pulmonary alteosis, pulmonary edema, pulmonary infection were all involved in the increrse of pulmonary shunt rate following intracra- nial hypertension. Conclusion Pulmonary shunt rate is an important marker of respiration dysfunction following intracranial hypertension.