【摘要】 目的研究兔盐酸诱导的弥漫性肺损伤后不同时间肺泡表面活性物质肺灌洗对急性肺损伤肺气体交换的影响。方法新西兰大白兔麻醉后纯氧机械通气15min,经气管导管注入0.0225N的盐酸12ml/kg,造成急性弥漫性肺损伤。注入盐酸1h后,动脉氧分压(PaO2)低于150mmHg的动物随机分为三个实验组和两个对照组,每组5只。实验组分别在盐酸注入后1h(T1组)、2h(T2组)、3h(T3组)采用天然肺泡表面活性物质肺灌洗;对照组在盐酸注入后1h(C1组)、2h(C2组)采用生理盐水肺灌洗。注入盐酸前、肺灌洗前、灌洗后30、60、90、120min测动脉血气值、气道峰压(PIP)。结果肺灌洗30min后T1组PaO2升高至300mmHg以上,T2组升高到200mmHg以上,T3组升高不明显;两对照组PaO2没有改善。T1、T2、T3组PIP、PaCO2轻度下降,后逐渐升高。结论早期采用肺表面活性物质灌洗对兔盐酸诱导的弥漫性肺损伤后肺气体交换有一定疗效。更多还原

【Abstract】 Objective To investigate the effect of lavage administration of pulmonary surfactant at different time intervals on pulmonary gas exchange after acute lung injury induced by hydrochloric acid in rabbits.Methods As the rabbits were anesthetized and mechanically ventilated via a tracheotomies, lung injury was induced by endotracheal instillation of 0.0225N hydrochloric acid （12ml/kg）. The rabbits with PaO₂ less than 150 mmHg 1h after the hydrochloric acid instillation were randomly divided into five groups, with 5 animals each. Lung lavage was then performed with surfactant solution （12mg/ml, 10ml/kg） 1 h after the hydrochloric acid instillation in group T₁, 2 h in group T₂ and 3h in group T₃.Normal saline was used to substitute the pulmonary surfactant 1 h after the hydrochloric acid instillation in group C₁ and 2 h in group C₂. Results PaO₂ after lung lavage dramatically improved in group T₁ and T₂ （P<0.01）, improved little in group T₃ and showed no improvement in group C₁ and C₂.The peak inspiratory pressure showed a tendency to increase too, but it was not statistically significant. Conclusion Early lavage administration of pulmonary surfactant may improve PaO₂ in acute lung injury rabbit induced by hydrochloric acid.更多还原