摘要目的 通过水囊叠加加压法制作机械通气改良腹腔高压(猪)液体动物模型,探索腹腔压力的变化规律.方法 以实验猪(8头)为研究对象,全身麻醉后气管插管后接呼吸机辅助呼吸,呼吸模式为容量控制通气(VCV),设定潮气量(VT) 10 ml/kg,呼吸频率16次/min,吸入氧浓度(FiO2)0.40,呼气末正压(PEEP)5 cmH2O(1 cmH2O =0.098 kPa).水囊叠加加压法制作腹腔高压液体动物模型,腹内压维持在35 cmH2O[25.74 mmHg(1 mmHg =0.133 kPa)],观察4h后通过加压管抽出加压水囊中生理盐水行腹腔减容,每抽出50 ml测压一次,绘制腹腔减容时压力-腹腔减容量变化曲线.抽液后处死实验动物,切取心脏、肺脏、肝脏、肾脏,行病理学观察.结果 8头家猪均制模成功,无1头发生气压伤和死亡;腹腔高压液体动物模型腹腔内压与腹腔引流量存在负相关关系,函数方程:Y=-0.118X +41.732(R2=0.973,P＜0.01).心脏、肺脏、肝脏、肾脏病理检查均出现细胞学损害.结论 机械通气腹腔高压液体动物模型可引起心、肺、肝、肾等脏器出现明显的细胞学损害,腹腔压力在减压后迅速下降.

abstractsObjective To establish a liquid animal model of mechanical ventilation to improve abdominal hypertension (pig) and explore the change rule of abdominal pressure.Methods The experimental pigs (8) were selected as the research subjects.After general anesthesia,the ventilator assisted respiration was performed after tracheal intubation.The breathing pattern was volume controlled ventilation (VCV),tidal volume (VT) 10 ml/kg,respiratory rate 16 times/min,inhaled oxygen concentration (FiO2) 0.40,PEEP 5 cmH2 0 (1 cmH2O =0.098 kPa).An animal model of abdominal hypertensive fluid was established by superimposing pressure with water sac (the intra-abdominal pressure was maintained at 35 cmH2O [25.74 mmHg (1 mmHg =0.133 kPa)].After 4 hours of observation,normal saline was extracted from the water sac by pressure tube for abdominal decompression.The pressure-abdominal decompression curve was drawn once every 50 ml.After extraction,the animals were sacrificed and their hearts,lungs,livers and kidneys were harvested for pathological observation.Results All the 8 pigs were successfully modeled,and none of them suffered from barotrauma or death.There is a negative correlation between intra-abdominal pressure and intra-abdominal drainage volume in the animal model of intra-abdominal hypertension.The function equation was Y =-0.118X + 41.732 (R2 =0.973,P ＜ 0.01).Pathological examination of heart,lung,liver and kidney showed cytological damage.Conclusion The abdominal pressure of mechanical ventilation abdominal hypertensive liquid animal model decreases rapidly after decompression,and can cause obvious cytological damage in heart,lung,liver,kidney and other organs.