国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2011年
6期
695-699
,共5页
魏福生%杨蕾%马龙先%钟钦文
魏福生%楊蕾%馬龍先%鐘欽文
위복생%양뢰%마룡선%종흠문
低温气体%机械通气%犬%体温%呼吸
低溫氣體%機械通氣%犬%體溫%呼吸
저온기체%궤계통기%견%체온%호흡
Cold air%Mechanical ventilation%Canine%Body temperature%Respiratory
目的 观察低温气体机械通气对犬体温、呼吸力学、血气参数值及肺组织病理的影响.方法 将健康雄性杂种犬18只,按随机数字表法均分为2组,即低温组(HG)和常温组(NG).气管插管后低温组和常温组分别用4℃低温气体和25℃常温气体行机械通气,犬气管插管后0 min作为基础值,连续观察240 min.每30 min分别观察并记录实验犬鼻咽温、腋温、血温；取机械通气0 min、1、2、3、4h5个时间点分别观察并记录实验犬动脉血气[氧分压(PaO2)、二氧化碳分压(PaCO2)、酸碱度(pH)]和呼吸力学参数[气道阻力(Raw)、气道峰压(PIP)、肺静态顺应性(Cstat)].机械通气0 min、2、4h3个时间点用ELISA法测白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度,最后取肺组织在光镜下观察其病理学变化.结果 低温组和常温组不同通气时间的体温(鼻咽温、腋温、血温)差异无统计学意义(P＞0.05),低温组和常温组各时间点的PaO2、PaCO2、pH及Raw、Ppeak、Cstat差异均无统计学意义(P＞ 0.05).在2、4h时间点的低温组和常温组IL-6水平显著高于基础值(P＜0.05),在通气2、4h时间点的低温组IL-6浓度分别为(0.292±0.024),(0.281±0.022) μg/L显著低于常温组相应时间点浓度(0.312±0.133),(0.301±0.031)μg/L;在2h时间点低温组和常温组TNF-α浓度显著高于基础值(P＜0.05),但在各时间点两组TNF-α浓度差异无统计学意义(P＞0.05)；低温组肺组织累积平均评分(2.44±1.03)显著低于常温组(4.01±1.31).结论 与常温气体机械通气相比4℃低温气体机械通气对犬的的体温、血气交换和呼吸力学没有明显的影响,但能抑制炎性因子(IL-6)的分泌,减轻肺组织病理损伤.
目的 觀察低溫氣體機械通氣對犬體溫、呼吸力學、血氣參數值及肺組織病理的影響.方法 將健康雄性雜種犬18隻,按隨機數字錶法均分為2組,即低溫組(HG)和常溫組(NG).氣管插管後低溫組和常溫組分彆用4℃低溫氣體和25℃常溫氣體行機械通氣,犬氣管插管後0 min作為基礎值,連續觀察240 min.每30 min分彆觀察併記錄實驗犬鼻嚥溫、腋溫、血溫；取機械通氣0 min、1、2、3、4h5箇時間點分彆觀察併記錄實驗犬動脈血氣[氧分壓(PaO2)、二氧化碳分壓(PaCO2)、痠堿度(pH)]和呼吸力學參數[氣道阻力(Raw)、氣道峰壓(PIP)、肺靜態順應性(Cstat)].機械通氣0 min、2、4h3箇時間點用ELISA法測白介素-6(IL-6)、腫瘤壞死因子-α(TNF-α)濃度,最後取肺組織在光鏡下觀察其病理學變化.結果 低溫組和常溫組不同通氣時間的體溫(鼻嚥溫、腋溫、血溫)差異無統計學意義(P＞0.05),低溫組和常溫組各時間點的PaO2、PaCO2、pH及Raw、Ppeak、Cstat差異均無統計學意義(P＞ 0.05).在2、4h時間點的低溫組和常溫組IL-6水平顯著高于基礎值(P＜0.05),在通氣2、4h時間點的低溫組IL-6濃度分彆為(0.292±0.024),(0.281±0.022) μg/L顯著低于常溫組相應時間點濃度(0.312±0.133),(0.301±0.031)μg/L;在2h時間點低溫組和常溫組TNF-α濃度顯著高于基礎值(P＜0.05),但在各時間點兩組TNF-α濃度差異無統計學意義(P＞0.05)；低溫組肺組織纍積平均評分(2.44±1.03)顯著低于常溫組(4.01±1.31).結論 與常溫氣體機械通氣相比4℃低溫氣體機械通氣對犬的的體溫、血氣交換和呼吸力學沒有明顯的影響,但能抑製炎性因子(IL-6)的分泌,減輕肺組織病理損傷.
목적 관찰저온기체궤계통기대견체온、호흡역학、혈기삼수치급폐조직병리적영향.방법 장건강웅성잡충견18지,안수궤수자표법균분위2조,즉저온조(HG)화상온조(NG).기관삽관후저온조화상온조분별용4℃저온기체화25℃상온기체행궤계통기,견기관삽관후0 min작위기출치,련속관찰240 min.매30 min분별관찰병기록실험견비인온、액온、혈온；취궤계통기0 min、1、2、3、4h5개시간점분별관찰병기록실험견동맥혈기[양분압(PaO2)、이양화탄분압(PaCO2)、산감도(pH)]화호흡역학삼수[기도조력(Raw)、기도봉압(PIP)、폐정태순응성(Cstat)].궤계통기0 min、2、4h3개시간점용ELISA법측백개소-6(IL-6)、종류배사인자-α(TNF-α)농도,최후취폐조직재광경하관찰기병이학변화.결과 저온조화상온조불동통기시간적체온(비인온、액온、혈온)차이무통계학의의(P＞0.05),저온조화상온조각시간점적PaO2、PaCO2、pH급Raw、Ppeak、Cstat차이균무통계학의의(P＞ 0.05).재2、4h시간점적저온조화상온조IL-6수평현저고우기출치(P＜0.05),재통기2、4h시간점적저온조IL-6농도분별위(0.292±0.024),(0.281±0.022) μg/L현저저우상온조상응시간점농도(0.312±0.133),(0.301±0.031)μg/L;재2h시간점저온조화상온조TNF-α농도현저고우기출치(P＜0.05),단재각시간점량조TNF-α농도차이무통계학의의(P＞0.05)；저온조폐조직루적평균평분(2.44±1.03)현저저우상온조(4.01±1.31).결론 여상온기체궤계통기상비4℃저온기체궤계통기대견적적체온、혈기교환화호흡역학몰유명현적영향,단능억제염성인자(IL-6)적분비,감경폐조직병리손상.
Objective To investigate the effect of mechanical ventilation with cold air on body temperature,pneodynamics,blood gas parameters and histological changes of lung tissue in dogs.Methods Eighteen healthy male dogs were randomly divided into two groups (n=9):hypothermia group and normothermia group.The animals were ventilated with cold air (4℃) or normal air (25℃) respectively.Ventilation parameters in each group were set as:VT=15 ml/kg,RR =15 bpm,I:E=1:2.The body temperatures(Tnp,Tb,Ta) were recorded immediately and repeated every 30 min until it counted to 240 min.Blood gas parameters (PaO2,PaCO2,pH) and pneodynamic parameters (Raw,Ppeak,Cstat) were measured at 0,30 min,1,2,3 h and 4 h after intubation.Plasma cytokine (TNF-α,IL-6) concentrations at 0 min,2 h and 4 h were measured using ELISA,and histopathologic appearance of lung tissue was observed under a light microscopy.Results There were no significant differences in body temperatures between the two groups (P＞0.05).There were no statistical significances in PaO2,PaCO2,pH,Raw,Ppeak,or Cstat values at different times between the hypothermia group and the normothermia group.Plasma IL-6 concentrations at 2 h and 4 h increased significantly in both groups compared with baseline values.However,concentrations of serum IL-6 at 2 h and 4 h were lower in hypothermia group compared with normothermia group[ (0.292 ±0.024) μg/L vs (0.312 ±0.133) μg/L at 2 h; (0.281±0.022) μg/L vs (0.301±0.031 ) μg/L at 4 h ].Plasma TNF-α concentration at 2 h increased in both groups compared with basal level.But there were no significant differences in plasma TNF-α concentration between the two groups.Cumulative mean histology scores showed lower in hypothermia group (2.44 ±1.03) than that in normothermia group (4.01±1.31,P＜0.05).Conclusion Compared with normal air mechanical ventilation,cold air ventilation at 4 ℃ has no effect on body temperature,pneodynamics or blood-gas exchange,but it has a beneficial effect on attenuating the elevation of serum IL-6 concentration and reducing the injury of lung tissue.
