【摘要】 目的:探讨静脉输注高氧液对家猪OLV时肺内分流与氧合的影响。方法:30头健康家猪(25~35 kg)建立OLV模型后,随机分为2组,每组15头,即高氧液组(H组)和对照组(C组),H组动物在单肺通气后经右静内静脉以15 mL.kg-.lh-l的速度恒速输入高氧液,C组动物则以相同的方式和速度输入等量的乳酸林格氏液。分别于双肺通气时、单肺通气30 min、单肺通气60 min时抽取动脉血和混合静脉血做血气分析,并计算肺内分流率(Qs/Qt%),同时记录血流动力学指标。结果:与双肺通气时相比,单肺通气时两组PaO2,SaO2,PvO2和SvO2均显著降低,而Qs/Qt%明显升高(P<0.01)。单肺通气30 min以及60 min后,H组的PaO2,SaO2,PvO2和SvO2等指标均显著高于C组(P<0.05),而对于肺内分流率(Qs/Qt%),两组间比较差异无统计学意义。结论:静脉输注高氧液虽然对肺内分流影响不大,却能够明显改善氧合,治疗单肺通气引起的低氧血症。更多还原

【Abstract】 Objective:To investigate whether intravenous hyper-oxygenated solution(HOS) infusion would improve systemic oxygenation and reduce intrapulmonary shunt during OLV.Methods:Thirty pigs(25~35 kg) were anesthetized,tracheally intubated,and mechanically ventilated.After placement of femoral arterial and pulmonary artery catheters,a left-sided double-lumen tube(DLT) was placed via tracheotomy.The animals were allocated randomly to one of the two study groups(n=15 each);control group(C group)and hyper-oxygenated solution group(H group).Animals in H group received intravenous HOS infusion immediately after the beginning of OLV via internal right jugular vein with an infusion pump,and the rate of infusion was 15ml · kg-l · h-l;and in C group,the same amount of lactate Ringer’s solution(LRS)was used in place of HOS.Arterial and venous blood gases analysis were recorded in three phases:during two-lung ventilation(TLV),30 min after beginning OLV(OLV+30),and 60 min after beginning OLV(OLV+60).We measured arterial oxygen saturation(SaO 2),mixing venous oxygen saturation(SVO 2),partial pressure of arterial oxygen(PaO 2),partial pressure of mixing venous oxygen(PvO 2),and venous admixture percentage(Qs/Qt%).Heart rate(HR),mean arterial pressure(MAP),mean pulmonary artery pressure(MPAP),and cardiac output(CO) were also recorded.Results:Initiation of OLV caused a significant decrease in PaO 2, SaO 2,PvO 2 and SvO 2,and a significant increase in Qs/Qt % during conversion from TLV to OLV in both groups(P<0.01).After 30 and 60 min OLV,the PaO 2,SaO 2,PvO 2,and SvO 2 values in H group were significantly higher than those in C group(P<0.05).When comparing the values of Qs/Qt % between the two groups in OLV+30 and OLV+60,there were no significant differences.Conclusions:Intravenous HOS infusion led to minimal changes in intrapulmonary shunt,nevertheless,could ameliorate arterial oxygenation obviously during OLV.This might be a new protective strategy against hypoxemia induced by OLV.更多还原