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对3例患者双侧肺行肺灌洗术,先行左肺灌洗术,1周后再行右肺灌洗术。每侧肺分别用高氧液和乳酸林格氏液交替灌洗,当脉搏血氧饱和度(SpO_2)高于92%时进行肺灌洗术,高氧液和乳酸林格氏液各灌洗10次,取其平均值。测定乳酸林格氏液和高氧液的氧分压；记录灌洗前即刻、灌洗10、20、30、40、50、60、70、80s时SpO_2及平均动脉压(MAP)、中心静脉压(CVP)、心率(HR)和呼吸末二氧化碳分压(P_(ET)CO_2)。左肺灌洗术后1周PaO_2为(72.3±2.1)mm Hg；右肺灌洗术后3d PaO_2为(83.5±4.8)mm Hg。所有患者均顺利出院。高氧液的氧分压[(780±4)mm Hg]高于乳酸林格氏液[(171±6)mm Hg]。与乳酸林格氏液比较,高氧液灌洗10～80s时SpO_2时升高(P＜0.05),MAP、CVP、HR、P_(ET)CO_2差异无统计学意义(P＞0.05)。在氧供方面PAP患者高氧液肺灌洗术的效果优于乳酸林格氏液。
Three patients underwent bilateral lung lavage with left lung lavage first and right lung lavage one week later. Lungs were rinsed alternately with hyperoxia solution and Ringer’s lactate solution respectively. Pulmonary lavage was performed when pulse oxygen saturation (SpO_2) was higher than 92% 10 times, whichever is the average. The oxygen partial pressure of Ringer’s lactate solution and hyperoxia solution was measured. SpO2 and mean arterial pressure (MAP) were recorded immediately before lavage and at 10, 20, 30, 40, 50, 60, Pressure (CVP), heart rate (HR) and end-tidal carbon dioxide partial pressure (P_ (ET) CO_2). PaO_2 was (72.3 ± 2.1) mm Hg one week after left lung lavage and PaO_2 was (83.5 ± 4.8) mm Hg 3d after right lung lavage. All patients were discharged smoothly. The oxygen partial pressure of hyperoxia liquid [(780 ± 4) mm Hg] was higher than [171 ± 6 mm Hg] of lactated Ringer’s solution. Compared with lactated Ringer ’s solution, there was no significant difference in MAP, CVP, HR and P_ (ET) CO_2 between 10 and 80s in lavage fluid at SpO_2 (P <0.05). Oxygen supply PAP patients with hyperoxic liquid lung lavage is better than lactated Ringer’s solution.