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制备犬蒸气吸入损伤模型 ,比较高频喷射通气时两种不同方向的喷射气流对呼吸、循环的不同影响 ,以了解气管内高频双向喷射通气机理。根据在呼气期增加气流的方向不同而分三种模式 :模式一为对照组 ,呼气期不增加任何气流 ;模式二 ,为呼气期增加反向气流 ;模式三 ,呼气期增加正向气流。实验结果表明 ,模式二通气效果优于模式一 ,表现为CO2 排出明显增加 (P <0 .0 1) ,PaCO2 明显减少 (P <0 .0 1) ,其机理可能是由于死腔减少。模式三与模式一比较解剖死腔和生理死腔虽然也有所减少 ,但通气效果反而恶化 ,其原因可能与呼气未正压及功能残气增加有关。我们初步认为 ,对于已发生Ⅱ型呼衰的吸入性损伤 ,宜用高频 (正反 )双向喷射通气 ,不宜采用高频喷射通气 +呼气未正压的通气方法。
The dog model of steam inhalation injury was prepared and the different effects of jet flow in two different directions on respiration and circulation during high frequency jet ventilation were compared to understand the high frequency bidirectional jet ventilation mechanism in the trachea. According to the direction of increasing air expiration during the expiration of three modes: the first model for the control group, the expiratory period does not increase any air flow; mode two, for the expiratory phase to increase reverse air flow; mode three, expiratory period increased positive To the air flow. The experimental results show that the mode II ventilation is superior to the mode one, showing a significant increase of CO2 emission (P <0.01) and a significant decrease of PaCO2 (P <0.01), which may be due to the decrease of dead space. Mode 3 and a mode of comparison Anatomical dead space and physiological dead space although it also decreased, but the ventilation effect worsened, the reason may be related to non-positive expiratory pressure and increased functional residual capacity. We initially believe that for inhalation injury has occurred in type Ⅱ respiratory failure, should use high-frequency (positive and negative) bidirectional jet ventilation, high-frequency jet ventilation should not be used + expiratory pressure is not positive ventilation method.