CAJ | 학술논문

目的评价内源性和外源性急性呼吸窘迫综合征(ARDS)对高频振荡通气(HFOV)改善幼猪血管外肺水和肺血管通透性效应的影响.方法健康幼猪12只,体重15 ～20 kg,采用随机数字表法,将其分为2组(n=6):内源性ARDS组(P组)和外源性ARDS组(EXP组).P组采用生理盐水灌洗肺的方法制备ARDS模型,EXP组采用静脉注射油酸的方法制备ARDS模型,随后HFOV治疗4h.于造模前(T0)、造模成功即刻(T1)、HFOV治疗1、2、3和4 h(T2-5)时,采集动脉血样行血气分析,计算氧合指数,监测血管外肺水指数和肺血管通透性指数,计算血管外肺水与胸腔内血容量比值.结果与T0时比较,2组T1时氧合指数降低,均低于200 mm Hg(P＜0.05)；2组血管外肺水指数、肺血管通透性指数和血管外肺水与胸腔内血容量比值的最大变化率比较差异无统计学意义(P＞0.05).结论内源性和外源性ARDS疾病因素对HFOV改善幼猪血管外肺水和肺血管通透性的效应无影响.
목적 평개내원성화외원성급성호흡군박종합정(ARDS)대고빈진탕통기(HFOV)개선유저혈관외폐수화폐혈관통투성효응적영향.방법 건강유저12지,체중15 ～20 kg,채용수궤수자표법,장기분위2조(n=6):내원성ARDS조(P조)화외원성ARDS조(EXP조).P조채용생리염수관세폐적방법제비ARDS모형,EXP조채용정맥주사유산적방법제비ARDS모형,수후HFOV치료4h.우조모전(T0)、조모성공즉각(T1)、HFOV치료1、2、3화4 h(T2-5)시,채집동맥혈양행혈기분석,계산양합지수,감측혈관외폐수지수화폐혈관통투성지수,계산혈관외폐수여흉강내혈용량비치.결과 여T0시비교,2조T1시양합지수강저,균저우200 mm Hg(P＜0.05)；2조혈관외폐수지수、폐혈관통투성지수화혈관외폐수여흉강내혈용량비치적최대변화솔비교차이무통계학의의(P＞0.05).결론 내원성화외원성ARDS질병인소대HFOV개선유저혈관외폐수화폐혈관통투성적효응무영향.
Objective To evaluate the effects of different types of acute respiratory distress syndrome (ARDS) on high frequency oscillatory ventilation (HFOV)-improved extravascular lung water and pulmonary vascular permeability in piglets.Methods Twelve healthy piglets,weighing 15-20 kg,were randomly allocated into 2 groups (n =6 each) using a random number table:endogenous ARDS (P group) and exogenous ARDS (EXP group).Anesthesia was induced with midazolam and propofol.The tracheal tube was inserted.Anesthesia was maintained with iv infusion of propofol and fentanyl.ARDS was induced with normal saline infused via the tracheal tube in group P.ARDS was induced with oleic acid 0.05 ml/kg injected intravenously over 45-60 min in group EXP.Then 4 h of HFOV was performed.Before ARDS (T0),immediately after ARDS (Ti) and at 1,2,3 and 4 h of HFOV (T2-5),arterial blood samples were collected for blood gas analysis and the variables such as extravascular lung water index (EVLWI),pulmonary vascular permeability index (PVPI),and extravascular lung water (EVLW)/intra thoracic blood volume (ITBV) were monitored.The oxygenation index (PaO2/FiO2) was calculated.Results Compared with the baseline value at T0,the oxygenation index was decreased at T1,and the oxygenation index was less than 200 mm Hg in the two groups (P ＜ 0.05).There was no significant difference in the maximum degree of changes in EVLWI,PVPI and EVLW/ITBV between the two groups (P ＞ 0.05).Conclusion Endogenous and exogenous ARDS disease factor does not affect HFOV-improved extravascular lung water and pulmonary vascular permeability in piglets.