部分液体通气对大鼠全氟异丁烯吸入急性肺损伤的治疗作用

Partial liquid ventilation in the treatment of rats with perfluoroisobutylene-induced lung injury

目的 :观察大鼠全氟异丁烯 (PFIB)吸入急性肺损伤 (ALI)模型中肺水肿和动脉血氧分压 (PaO2 )随时间变化规律 ,对比部分液体通气 (PLV)和传统机械通气 (CMV)对大鼠PFIB吸入急性肺损伤的治疗作用。方法 :(1) 2 1只大鼠随机分为 7组 ,分别于染毒前、染毒后 2 ,4 ,8,12 ,16 ,2 4h颈动脉取血测血气 ;取左肺一叶称重 ,计算湿肺 /体比。(2 ) 32只大鼠随机分为 4组 ,正常对照组、染毒对照组、机械通气组、部分液体通气组。所有动物乌拉坦麻醉后行气管插管和颈动脉插管 ,于染毒后 8h机械通气组和部分液体通气组开始通气 ,各组每 1h取血测血气并计算氧合指数 ,3h后放血处死 ,测定静态吸气相P V曲线。结果 :大鼠吸入全氟异丁烯后湿肺 /体比与PaO2 呈线性负相关 ,湿肺 /体比和PaO2 于染毒后 8h开始分别显著升高和下降 ,并于 12h达到峰值 ,2 4h内无明显改善。机械通气 1h即可显著改善氧合指数 ,部分液体通气 3h才显效。液体通气组和机械通气组均可提高肺顺应性 ,在低压力区液体通气组更明显 ,但部分液体通气并未使P V曲线的低位曲折点左移。结论 :对于全氟异丁烯吸入急性肺损伤 ,与传统机械通气相比 。

Objective: To determine whether partial liquid ventilation (PLV) is more effective than conventional mechanical ventilation (CMV) for rat model of perfluoroisobutylene (PFIB) intoxication. Methods: First, wet lung /body weight ratio and PaO 2 were studied at 2, 4, 8, 12, 16, 24 h after an acute exposure to PFIB. Secondly, adult rats were randomly divided into four groups, namely normal control, untreated control, PLV treatment and CMV treatment. A tracheostomy tube and carotid artery catheter were placed in each anesthetized animal for ventilation and blood gas analysis. The observation period was 8-11 h after exposure to PFIB. Thereafter, all animals were killed and static inspiration P-V curve was determined. Results: There was a unique postexposure latent period (approximately 8 h) prior to the occurrence of overt pulmonary edema. CMV took effect more rapidly than PLV, and both treatments could improve lung compliance. Conclusion: Although PLV can improve gas exchange and compliance, it was not proved to be more useful in ALI induced by PFIB than CMV.