高压氧、机械通气对海水淹溺肺水肿兔肺组织学及呼吸功能的影响

目的　观察高压氧 (HBO)、机械通气对海水淹溺肺水肿 (PE- SWD)兔肺组织学及呼吸功能的影响。方法　将 2 4只实验动物随机分为 PE- SWD组、HBO治疗组、机械通气治疗组。在不同时间点观察动脉血气分析、呼吸频率、呼吸动力学指标 ,实验结束后进行肺组织病理学检查。结果　 HBO治疗组、机械通气治疗组各相同时间点 Pa O2 明显高于 PE- SWD组 (P<0 .0 1) ;HBO治疗组除个别时间点外 ,p H、Pa CO2 在整个治疗过程中变化不明显 ;机械通气治疗后 p H的变化规律略与 PE- SWD组相同 ,但治疗结束时仍低于其他组 (P<0 .0 1) ,Pa CO2 始终维持在一个较高的水平 (P<0 .0 1)。两种治疗都减轻了肺损伤程度 ,在降低气道峰压、提高肺顺应性方面两治疗组之间比较 ,差异无显著性意义 (P>0 .0 5 )。结论　 HBO和机械通气治疗可明显纠正 PE- SWD时的低氧血症 ,减轻肺损伤程度 ,改善呼吸功能。

The effect of hyperbaric oxygen and mechanical ventilation on lung histology and respiratory function of pulmonary edema after seawater drowning in rabbits

Objective To observe the effect of hyperbaric oxygen(HBO) and mechanical ventilation on lung histology and respiratory function of pulmonary edema after seawater drowning(PE SWD)in rabbits. Methods Z Twenty four rabbits were randomly divided into three groups:PE SWD group,HBO therapy group and mechanical ventilation group. Blood gas analysis , respiratory rate and pneodynamic status were monitored at various time points. After experiment, the rabbits of each group were killed for pathological examination. Results PaO 2 was significantly improved after HBO therapy or mechanical ventilation therapy( P <0 01).pH and PaCO 2 of HBO therapy group did not change very obviously except for individual time points. pH changes of mechanical ventilation group were as same as PE SWD group. At the end of experiment, pH of mechanical ventilation group was lower than other groups( P <0 01). And PaCO 2 kept on a higher level( P <0 01). The degree of lung injury was relieved after therapy. HBO or mechanical ventilation could decrease airway peak pressure and increase pulmonary compliance( P >0 05). Conclusions Our study showed that HBO therapy and mechanical ventilation significantly improved hypoxemia of PE SWD in rabbits, relieved the degree of lung injury to some extend and improved respiratory function.