氦-氧混合气治疗哮喘的机理及临床应用探讨

目的探讨氦－氧混合气（Ｈｅｌｉｏｘ，２１％Ｏ２～７９％Ｈｅ）对气道痉挛模型犬及支气管哮喘急性发作患者的作用。方法选择６只健康杂种犬，激发气道痉挛后每次分别吸入Ｈｅｌｉｏｘ和空气（１２ｍｌ／ｋｇ），观察呼吸力学、血液动力学及血气的变化；选择支气管哮喘急性发作患者８例，应用自制的重复利用氦气装置，观察吸入Ｈｅｌｉｏｘ后肺功能、血气的变化。结果Ｈｅｌｉｏｘ可以迅速降低气道压力、气道阻力，降低呼吸功耗，提高肺顺应性；可以促进氧合，提高动脉血氧分压，促进二氧化碳的排除，但后续效应短暂。我们研制的循环式氦－氧混合气辅助呼吸装置可以显著节省氦气消耗，临床应用效果理想。结论Ｈｅｌｉｏｘ可以降低气道压力，促进氧合，促进二氧化碳排除。故而吸入Ｈｅｌｉｏｘ是治疗哮喘的有效手段之一。

The experimental and clinical study of heliox in treating bronchial asthma

Objective To evaluate the effects of breathing helium oxygen(heliox:79%He 21%O 2) on bronchial asthma by way of experimental and clinical observations. Method Six mongrel dogs were randomly inspired air or heliox after dripping 2% methacholine in its' tracheas controlled by 900C ventilator. During the experimental course, respiratory mechanical limits, hemodynamic index and blood gas values were observed. Eight asthmatic patients inspired heliox with assisted respirator of recycle used helium, and the data of pulmonary function tests,arterial blood gas values of patients were recorded.Result The results demonstrated that heliox could reduce airway resistance,airway pressure and work of breathing, improve lung effective compliance, but had no effects on pulmonary circulation and systemic circulation. Heliox could ameliorate oxygen diffusion and CO 2 eliminating, but the duration was very short after stopping breathing heliox. The assisted respirator of recycle used helium could save helium distinctively, and the clinical application demonstrated that the instrument may be useful for pulmonary obstructive diseases. Conclusion Heliox can reduce airway pressure, ameliorate oxygen diffusion and CO 2 eliminating, so breathing heliox might be one of effective ways for asthmatic patients.