肺泡表面活性物质肺灌洗时机对兔急性肺损伤后动脉氧分压影响

目的:研究盐酸诱导的弥漫性肺损伤后不同时间肺表面活性物质肺灌洗对动脉氧分压的影响。方法:新西兰大白兔麻醉后纯氧机械通气15 min,经气管导管注入0.0 225mol/L的盐酸12 ml/kg,造成急性肺损伤。注入盐酸1 h后,动脉氧分压(PaO2)低于150 mmHg的动物随机分为两个实验组和两个对照组,每组5只,实验组分别在盐酸注入后1 h(T1组)2、h(T2组)采用天然肺泡表面活性物质肺灌洗,对照组在盐酸注入后1 h(C1组)、2 h(C2组)采用生理盐水肺灌洗。注入盐酸前、肺灌洗前、灌洗30 min、灌洗60 min、灌洗90 min、灌洗120 min测动脉血气值、其余时间每1 h监测一次。结果:肺灌洗30 min后T1组PaO2升高至300mmHg以上,随后逐渐下降;T2组PaO2升高到200 mmHg以上,随后呈下降趋势;两组对照组PaO2没有改善。结论:早期采用肺表面活性物质肺灌洗可改善盐酸诱导的肺损伤兔的动脉氧分压。

Lavage administration of pulmonary surfactant at different time on PaO2 after acute lung injury induced by hydrochloric acid in rabbits

Objective:To investigate the effect of lavage administration of pulmonary surfactant at different time interval on PaO_2 after acute lung injury(ALI)induced by hydrochloric acid in rabbits.Methods: As the rabbits were anesthetized and mechanically ventilated via a tracheotomies,lung injury was then induced by endotracheal instillation of 0.0225 mol/L hydrochloric acid(12 ml/kg).The rabbits with PaO_2 less than 150 mmHg 1 hour after the hydrochloric acid instillation were randomly divided into four groups,with 5 animals each.Lung lavage was then performed with surfactant solution(12 mg/ml,10 ml/kg) 1 hour after the hydrochloric acid instillation in the groupT_1,2 hours in the group T_2.Normal saline was used to substitute the pulmonary surfactant 1 hour after the hydrochloric acid instillation in the group C_1 and 2 hours in the group C_2.Results: PaO_2 dramatically improved in group T_1 and group T_2(P<0.01) after the lung lavage,and showed no improvement in group C_1 and C_2.Conclusion: Early lavage administration of pulmonary surfactant may improve PaO_2 in acute lung injury rabbit induced by hydrochloric acid.