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高频通气对海水淹溺肺水肿肺弥散功能的影响
Effect of high frequency jet ventilation on pulmonary diffusion function in pulmonary edema after seawater drowning
【摘要】 目的探讨高频喷射通气(HFJV)对海水淹溺肺水肿(PESWD)肺弥散功能的影响,对PESWD进行HFJV治疗。观察和分析了HFJV对PESWD肺弥散功能的影响,探讨HFJV的治疗机制。方法应用血气酸碱分析仪和计算机图像分析系统,对兔动脉血气酸碱6项指标和肺毛细血管内皮细胞Na+K+ATPase9项参数进行自动检测和定量测量。结果HFJV组PaO2、血氧饱和度(SO2)、pH、实际碳酸氢盐(AB)、碱剩余(BE)和肺毛细血管内皮细胞Na+K+ATPase活力均比PESWD组明显升高(P<0.01或P<0.05)。但每项指标均未能恢复到灌海水前的正常水平。PaCO2在两组之间差异无显著性。结论HFJV可较好地增加PESWD肺泡弥散面积,减少弥散膜的厚度,调节肺泡通气与血流(VA/Q)比例失调,改善肺的弥散功能。若与其它救治措施综合应用,可望获得更好的疗效
【Abstract】 Objective To study the effect of high frequency jet ventilation(HFJV) on pulmonary diffusion function in pulmonary edema after seawater drowning(PE SWD) and treatment mechanism of HFJV. Methods 6 indexes of blood gas and acid base and 9 parameters of Na + K + ATPase in the endothelial cells of the lung capillaries were observed and measured by the blood gas analyser and computer image analysing system. Results PaO 2,oxygen saturation(SO 2),pH,actual bicarbonate(AB),base excess(BE) and Na + K + ATPase activity in the endothelial cells of the lung capillaries in HFJV group are significantly higher than in PE SWD group( P <0.01 or P <0.05).But they did not all recover to normal level before instillation. PaCO 2 in PE SWD group was not obviously different from that in HFJV group. Conclusions HFJV treatment may increase the area of alveolus diffusion,decrease the thickness of diffusion membrane,regulate V A/Q imbalance and improve pulmonary diffusion function.If HFJV combines with other measures,better therapeutic effect may be obtained.
【Key words】 High freguency jet ventilation Pulmonary edema Seawater drowning Blood gas analysis Na + K + ATPase;
- 【文献出处】 中华劳动卫生职业病杂志 ,CHINESE JOURNAL OF INDUSREIAL HYGIENE AND DCCUPATIONAL DISEASES , 编辑部邮箱 ,1999年02期
- 【分类号】R649.302
- 【被引频次】1
- 【下载频次】26