摘要目的 制作海水淹溺型呼吸窘迫综合征(SW-RDS)兔模型,观察全氟化碳(PFC)汽化吸入对SW-RDS的治疗作用.方法 将27只健康雌性新丙兰兔按随机数字表法分为常规通气组(CMV组)、PFC汽化吸人组(PFC组)和对照组,每组8只,余3只为空白对照.采用人工海水2 ml/kg气管内注入建立动物模型.CMV组模型建立成功后采用常规通气治疗6 h后处死(潮气量为8 ml/kg);PFC组模型建立成功后先汽化吸人PFC(6～7 ml·ks~(-1)·h~(-1))2 h,后调整为常规通气继续治疗4 h后处死;对照组动物模型成功后不予治疗,观察自然死亡时间.将处死动物右肺游离并结扎,取右肺下叶组织2～3块制备病理切片,观察肺组织病理结构改变.另取3只动物麻醉后直接处死观察正常兔肺组织结构.结果 SW-RDS兔模型建立成功后其氧合指数和呼吸力学指标明显恶化,应用常规通气治疗上述指标无改善,肺组织损伤继续加重,PFC组在PFC汽化吸入治疗30 min后氧合指数(158±65)明显高于CMV组(74±12,F=26,P<0.05);肺顺应性为(2±1)mm Hg/cm H_2O(1 mm Hg=0.133 kPa,1 cm H_2O=0.098 kPa),高于CMV组的(1±0)mm Hg/cm H_20(F=20.P<0.05);肺组织病理评分(6.9±1.6)低于CMV组(9.8±1.3)(X~2=22,P<0.05),肺泡不同程度复张.此外,在停止PFC汽化后,氧合改善作用仍能维持4 h[PFC为(253±96)mm Hg,CMV组为(78±19)mm Hg,F=15,P<0.05].结论 PFC汽化吸入不仅可改善SW-RDS兔的氧合状态并可维持一定的时间,同时可改善肺顺应性,减轻肺组织损伤.

abstractsObjective To investigate the effects of vaporized perfluorocarbon therapy on pulmonary gas exchange and lung compliance in seawater respiratory distress syndrome rabbit models.Methods After induction of seawater respiratory distress syndrome by means of intratracheal injection of seawater,24 female among the 3 groups by analysis of variance.The right lung of each animalwas cut into 2 or 3 slides which were fixed with 10% buffered formalin for pathological evaluation.Results After lung injury.the measurements of lung compliance and oxygenation became significantly worse.After vaporized PFC for 30 min,lung compliance and oxygenation improved significantly as compared to the CMV group[(2±1)mm Hg/cm H_2O vs(1±0)mm Hg/cm H_2O(1 mm Hg=0.133 KPa,1 cm H_2O=0.098 kPa),F=20,P<0.05;(158±65)mm Hg vs (74±12)mm Hg,F=26,P<0.05].After PFC inhalation,the improvement of oxygenation in PFC group lasted for 4 h[(253±96)mm Hg vs(78±19)mm Hg,F=15,P<0.05].The lung injury score was also decreased in the PFC group compared to the CMV group(6.9±1.6 vs 9.8±1.3,X~2=22,P<0.05).All animals in the control group died in 15 min without ventilation.Conclusion Vaporized PFC improved oxygenation and lung compliance and attenuated lung injury in a rat model of seawater induced respiratory distress syndrome.