肺泡表面活性物质肺灌洗对急性呼吸窘迫综合征PaCO_2及PIP的影响

目的 研究肺泡表面活性物质肺灌洗治疗急性呼吸窘迫综合征(ARDS)的效果.方法 用12 ml/kg 0.0225 N的盐酸注入新两兰白兔气管内,纯氧机械通气1h后,将符合PaO_2/FiO_2≤150mm Hg的动物随机分成五组.每组5只.分别用生理盐水(NS组)、浓度为1 g/L(S_1组)、3g/l(S_3组)、6g/L(S_6组)、12g/L(S_(12)组)的肺泡表面活性物质肺灌洗.灌洗容量为10 ml/kg.观察治疗后的PaCO_2和气道吸气峰压(PIP)变化,并对肺标本行病理切片检查.结果 S_3组、S_6组、S_(12)组肺灌洗后PaCO_2明显改善,但效果不能持久.S_3组、S_6组、S_(12)组中肺泡间质允血水肿较NS组、S_1组明显减轻.结论 采用浓度为3g/L以上的外源性肺泡表而活性物质对盐酸诱导的ARDS行肺灌洗治疗可以改善肺通气,但效果不能持久.

Effect of surfactant lavage on pulmonary gas exchange in rabbit with ARDS induced by hydrochloric acid

Objective To evahmte the effect of surfactant irrigation on pulmonary gas Pxchangein rabbit with ARDS induced by hydrochloric acid.Methods After the rabbits were anesthetized and 0.0225 N hydrochloric acid(12 ml/kg).After ventilated for l hour,the animals with PaO_2/FiO_2≤:150 mm Hg were then randomized into five groups with five animals each. lung lavage、was thenperformed with saline in group NS,1 g/L pulmonary surfactant in group S_1,3 g/L in group S,6 g/L in group S_6 ,or 12 g/L in group S_(12).The lavage volume was 12 ml/kg in all rabbits.Results PaCO_2dccreased markedly in a short period of about 90 minutes in groups of S_3,S_6 and S_12 with less alveolarpathological changes than those in groups of NS and S1(P<0.05).Conclusion Lung lavage withpulmonary surtactant 3g/L or more can improve pulmonary gas exchange in rabbits with hydrochloric acid-induced lung inj ury temporarily.