严重肺挫伤及休克缺血再灌注早期呼吸功能变化

目的研究兔严重肺挫伤及休克缺血再灌注早期呼吸功能变化。方法25只实验兔随机分为严重肺挫伤组(SLC,n=10)、严重肺挫伤休克缺血再灌注组(SLC+IR,n=10)和对照组(MC,n=5),建立动物模型,在挫伤前及挫伤后1、2、3、4小时各时点监测心率、血压、呼吸频率、潮气量、气道压力、呼吸流率曲线、呼气末CO2浓度、动脉血气分析及动静脉混和血气分析,根据公式计算出每分钟通气量、肺泡通气量、肺内分流、肺泡-动脉血氧分压差、肺顺应性、气道阻力及生理死腔与潮气量之比,用以评价肺通气功能、换气功能及呼吸力学的变化。结果肺挫伤及休克再灌注后1h实验兔呼吸频率变浅变快,出现明显的肺内肺分流(p<0.05);肺挫伤及休克再灌注后2h实验兔生理死腔/潮气量明显增加,休克再灌注组肺泡-动脉血氧分压差亦增大明显(p<0.05);肺挫伤及休克再灌注后3～4h实验兔肺泡通气量降低、动脉血压分压下降(p<0.05),肺顺应性降低,肺阻力增大(p<0.01)。结论严重肺挫伤及休克再灌注后1～2h已有通气功能损害,3～4h通气功能、换气功能及呼吸力学损害更明显,并且严重肺挫伤合并休克呼吸功能损害比单纯肺挫伤损害出现早且严重。

EARLY VARIETY OF BREATHING FUNCTION INDUCED BY SEVERE LUNG CONTUSION AND ISCHEMIA-REPERFUSION INJURY IN RABBIT

Objective To investage early changing of breathing function induced by severe lung contusion and ischemia-reperfusion injury in rabbit.Methods 25 experiment rabbits were random divided into a serious lung contusion set(n=10),serious lung contusion combinated ischemia-reperfusion injury(n=10)and matched control(n=5).The establishment animal model,at before bruising and contusion after 1,2,3,and 4 hours were each order monitor heart rate,blood pressure,breathe frequency,dampness quantity,spirit way pressure,breathe and flow rate curve,breathe out end CO_2 density,artery guts the analysis and action vein mix guts analysis,computing according to the formula an every minute ventilates quantity,lung bubble and ventilates reposition of redundant personnel inside the quantity,lung,lung bubble-artery blood oxygen the cent press bad,lung conformance,spirit way resistance and physiology die chamber and amount of dampness of ratio,evaluate lung and ventilate function and change a Chi Kung in order to ability and breath mechanics of variety.Results Lung contusion and ischemia-reperfusion injury to note behind test rabbit breath frequency to become for an hour shallow become quickly,appear lung reposition of redundant personnel inside the obvious lung(p<0.05);Lung contusion and ischemia-reperfusion injury to note behind test the quantity obvious increment of the rabbit physiology dead chamber/dampness for 2 hours,and ischemia-reperfusion injury to note a set of lung bubble-artery blood oxygen the cent press bad also enlarge obviously(p<0.05);Lung contusion and shock test rabbit lung a bubble to ventilate quantity to lower for 3～4 hours after infusing again note,artery blood pressure the cent press down to decline(p<0.05),the lung conformance lowers,lung resistance enlarge(p<0.01).Conclusion Severity lung contusion and ischemia-reperfusion injury to note behind had already ventilated function damage for 1～2 hours,ventilate function for 3～4 hours and change a Chi Kung ability and breath the mechanics all have obvious damage,and the serious lung contusion merger shock to breathe function of the damage than the single lung contusion.