地塞米松对海水淹溺性肺水肿兔缺氧及肺水肿的改善

目的:观察地塞米松对海水淹溺性肺水肿兔的动脉血氧分压(PaO2)及肺水肿的影响.方法:24只兔随机分成对照组和地塞米松治疗组,每组各12只.制备海水淹溺性肺水肿机械通气模型后,地塞米松治疗组在海水灌注20 min后经颈动脉注射地塞米松(1 mg/kg),对照组则注入2 ml生理盐水.观察海水灌注前即刻、海水灌注后20 min和180 min的PaO2、PaCO2、胸肺静态顺应性(CT)、动态顺应性(CD),并检测血管外肺水含量指数(EVLWI)及伊文思兰漏出指数(ELI).结果:两组海水灌注前即刻和海水灌注后20 min的PaO2、PaCO2、CT及CD均无统计学差异,但海水灌注后180 min地塞米松治疗组的PaO2、CT及CD均显著高于对照组,而PaCO2显著低于对照组(P<0.05).地塞米松治疗组的EVLWI和ELI均低于对照组(P<0.05).结论:地塞米松可改善海水淹溺性肺水肿兔的缺氧及减轻肺水肿.

Improving effect of dexamethasone on hypoxia and pulmonary edema in rabbits with seawater drowning induced pulmonary edema

Objective:To study the improving effect of dexamethasone on hypoxia and pulmonary edema in rabbits with seawater drowning induced pulmonary edema.Methods: Twenty-four ventilated New Zealand rabbits were instilled by seawater(4 ml/kg body weight) into lower trachea and were then equally randomized into the control group(CG) and the dexamethasone treatment group(DG).Rabbits in DG group were injected with dexamethasone(1 mg/kg body weight) on 20 min after seawater instillation and rabbits in CG group with 2 ml normal saline.PaO_(2),PaCO_(2),static compliance(C_(T)) and dynamic compliance(C_(D)) were observed before and after(20 min and 180 min) seawater drowning experiment;extravascular lung water index(EVLWI) and Evan's blue leakage index(ELI) were also determined in 2 groups.Results: At 180 min after seawater instillation,the PaO_(2),C_(T) and C_(D) in DG group were significantly higher and PaCO_(2)was significantly lower than those in CG group(P<0.05).EVLWI and ELI in DG group were also significantly lower than those in CG group(P<0.05).Conclusion: Dexamethasone can relieve hypoxia and pulmonary edema after seawater drowning in rabbits.