不同时间单肺通气后兔两侧肺损伤程度比较

目的观察不同长度时间单肺通气后,两侧肺的氧合指数、肺损伤评分及湿/干质量比的变化。方法24只日本大耳白兔随机分为4组各6只。对照组(C组)双肺通气2h;O1组、O2组及O3组为单肺通气组,采用自制双腔气管导管建立单肺通气模型后,分别单肺通气1、2、3h,随后恢复双肺通气1h。在实验结束前开胸,分别由两侧肺静脉同时抽取肺静脉血、由股动脉抽取动脉血做血气分析测定氧合指数。实验结束后处死动物测肺组织湿/干质量比并做肺组织病理切片行肺损伤评分。结果肺损伤评分C组左右侧相比较差异无统计学意义(P>0.05),另三组组内左右侧比较左侧明显增高(P<0.01);各组间右侧比较表现为逐步升高,其中O3组最明显;各组间左侧相比较亦表现为逐步升高。肺组织湿/干质量比及氧合指数的变化与之相对应。结论长时间单肺通气可以导致急性肺损伤,这种损伤是不均一性的,损伤的程度与单肺通气时间相关,且非通气侧肺要比通气侧肺损伤严重。

Comparison of lung injury degrees after one -lung ventilation for different time

Objective To study the changes of oxygenation index,lung injury score and wet/dry lung weight ratio (W/D) after one lung ventilation for different duration on the rabbit models.Method 24 white Japanese rabbits were randomly divided into 4 groups (n=6). The control group performs two-lung ventilation for 2 h. The groups of O1,O2 and O3 performed one-lung ventilation for 1,2,3 h respectively, which were followed with two-lung ventilation for 1 h. Lung separation was achieved with a double-lumen tube made by myself. The arterial blood gas samples were drawn from femoral artery,the right pulmonary vein and the left one to get the oxygenation indexes. Light microscopic evaluations were performed to get the lung injury scores and W/D were determined. Result Lung injury scores were significant differences in left lung compared to right lung in the groups of O1,O2 and O3, though no significant differences were noted in the group C. Comparison of the right lungs of the four groups to all other documented significant increase of lung injury scores. The magnitudes of lung injury scores were related to OLV duration. The changes in the left lung were similar and more severe to the right ones. A similar changes of oxygenation index and W/D was found in all the groups.Conclusion Long time OLV could induced acute lung injury, which was inhomogeneous. The degrees of lung injury were related to OLV duration and were more severe in the non-ventilated lung.