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目的 比较间歇正压通气 (IPPV)和高频喷射通气(HFJV)对胸部火器伤致肺损伤犬的早期救治作用 .方法 杂种犬 19只 ,随机分为对照组 (6只 )、IPPV组 (8只 )和 HFJV组 (5只 ) 3组 .麻醉后利用 0 .4g钢珠弹射击犬右侧胸部 .对照组犬仅进行封闭伤口、输液及胸腔闭式引流等 . IPPV组和HFJV犬除进行上述操作外 ,分别于致伤后 2 0 min行 IPPV和 HFJV.测量血液动力学等指标 ,并做血气分析 .结果 致伤即刻 ,对照组犬平均动脉压 (pa)和峰值气道压 (ppi)较致伤前显著升高 (P<0 .0 5 ) ;致伤后 2 0 m in,pao2 ,p H,Sa O2 ,(pa 及心率 (fh)等均显著降低 (P <0 .0 1) ,paco2 及 ppi显著升高 (P<0 .0 1) ;致伤后 40 min及 6 0 min,上述变化呈渐进性加剧 ,动物平均存活时间为 (38± 2 5 ) m in. IPPV组和 HFJV组犬在致伤即刻及 2 0 min,上述指标变化与对照组相似 ;应用 IPPV或 HFJV后 ,pao2 ,Sa O2 ,(pa,fh及 ppi较对照组均显著升高 (P<0 .0 1) ,paco2 显著降低 (P<0 .0 1) ,动物存活时间明显延长 .IPPV和 HFJV组动物平均存活时间分别为 (46 9± 32 8) min和 (36 6± 2 10 ) min.结论 严重胸部火器伤致肺损伤犬早期即可出现明显的呼吸功能不全 .应用 IPPV或 HFJV均可改善胸部火器伤致肺损伤犬的气体交换 ,显著延
Objective To compare the early treatment effect of IPPV and HFJV on lung injury caused by chest firearm injury in dogs.Methods Nineteen canine dogs were randomly divided into control group (6), IPPV group (8) Only) and HFJV group (5) 3. After the anesthesia, the right chest of the dog was shot with 0.4g steel ball.The dog in the control group was only closed wound, infusion and closed thoracic drainage, etc. IPPV group and HFJV dog except the above After operation, IPPV and HFJV were respectively administered at 20 min after injury.Herodynamics and other indexes were measured and blood gas analysis was performed.Results The mean arterial pressure (pa) and peak airway pressure ppi) significantly increased compared with that before injury (P <0.05). The levels of paO2, p H, Sa O2, (pa) and heart rate (fh) (P <0.01); paco2 and ppi were significantly increased (P <0. 01); 40 min and 60 min after injury, the above changes gradually increased, the average survival time of animals was (38 ± 25) m in IPPV group and HFJV group, the changes of these indexes were similar to those of the control group immediately after the injury and at 20 min, and the levels of pao2, Sa O2, (pa, fh and ppi) were significantly increased after IPPV or HFJV administration (P <0.01), paco2 decreased significantly (P <0.01), and the survival time of animals significantly prolonged.The average survival time of animals in bothIPPV and HFJV groups was (46 9 ± 32 8) min and (36 6 ± 2 10) min. Conclusion Severe chest firearm injury can cause obvious respiratory dysfunction in the early stage of lung injury.Application of IPPV or HFJV can improve gas exchange in dogs with lung injury caused by chest firearm injury