肺泡表面活性物质灌洗的浓度和时间对急性呼吸窘迫综合征治疗效果的影响

• 作 者: 刘辉 王国军 丁正年
• 机 构: 江苏省肿瘤医院麻醉科,南京四五四医院,南京医科大学第一附属医院麻醉科,
• 出 处: 江苏医药
• 发表日期: 2011年16期
• 关键词: 急性呼吸窘迫综合征 肺泡表面活性物质 肺灌洗

目的观察肺泡表面活性物质(SF)灌洗的浓度和时间对急性呼吸窘迫综合征(ARDS)治疗效果的影响。方法用0.0225N盐酸12ml/kg注入新西兰白兔气管内,建立ARDS模型后随机分成七组,每组5只。在盐酸注入后1h用浓度为1、3、6和12g/L的SF肺灌洗,2和3h用浓度为12g/L的SF肺灌洗;对照组用生理盐水灌洗。观察治疗前后二氧化碳分压(PaCO2)和气道吸气峰压(PIP)变化;并对肺标本行病理检查。结果造模1h后,3、6和12g/L的SF灌洗均明显降低PaCO2,作用持续1.5h;造模2h后用浓度为12g/L灌洗组PaCO2降低作用可持续2h。但3h组PaCO2未见降低。各灌洗组均不能降低PIP。结论盐酸造模后2h内进行SF3～12g/L肺灌洗可改善肺换气功能。

Objective To investigate the effect of lavage of alveolar surfactant (SF) on the therapeutic effect of acute respiratory distress syndrome (ARDS). Methods 0.0225N hydrochloric acid 12ml / kg was injected into the trachea of ​​New Zealand white rabbits. ARDS models were established and randomly divided into seven groups of five. Lungs were irrigated with SF lungs at 1, 6, and 12 g / L concentrations 1 h after HCI injection, SF lungs at 12 g / L concentrations at 2 and 3 h, and normal saline. The changes of PaCO2 and PIP before and after treatment were observed. Pathological examination of lung specimens was performed. Results After 1 h of modeling, PaCO2 was significantly decreased at 3, 6 and 12 g / L of SF, and the effect lasted for 1.5 h. After 2 h of modeling, PaCO2 was reduced by 12 g / L lavage for 2 h. PaCO2 was not reduced in 3h group. Each lavage group can not reduce PIP. Conclusion Hydrochloric acid (SF3) 12g / L pulmonary lavage can improve pulmonary ventilation function within 2 hours after modeling.