CAJ | 학술논문

目的：观察单肺通气（OLV）时降低吸入氧浓度（FiO2）对兔肺损伤的影响。方法新西兰白兔30只，随机均分为三组：60% FiO2组（L组）、100% FiO2组（H组）和对照组即双肺通气（TLV）组（C组，60% FiO2）。L组和H组TLV 30 min后行右OLV 3 h，C组TLV 30 min后继续TLV 3 h。三组于TLV 30 min（T0）和OLV 10 min（T1）、30 min（T2）、60 min（T3）、120 min （T4）、180 min（T5）时抽取动脉血行血气分析并计算氧合指数（OI）。股动脉置管监测血压（ABP）、心率（HR），记录气道峰压（P peak ）。各组实验结束后处死动物，取双侧肺组织行肺病理组织学损伤评分，并测量双侧肺组织匀浆液中超氧化物歧化酶（SOD）和丙二醛（MDA）含量。结果与H组比较，L组动脉氧分压（PaO2）在T4、T5时明显降低，动脉氧饱和度（SaO2）在T5时明显降低， T5时SOD含量明显增高，MDA含量明显降低，肺损伤评分降低（P＜0.05）；H组镜下肺泡腔内可见大量红细胞渗出，L组镜下可见较少的炎性细胞浸润、肺泡渗出液、肺泡间质破坏。结论 OLV时降低FiO 2到60%虽然增加低氧血症的发生率，但能显著减轻兔肺损伤，这可能与减轻了肺组织氧化应激水平有关。
목적：관찰단폐통기（OLV）시강저흡입양농도（FiO2）대토폐손상적영향。방법신서란백토30지，수궤균분위삼조：60% FiO2조（L조）、100% FiO2조（H조）화대조조즉쌍폐통기（TLV）조（C조，60% FiO2）。L조화H조TLV 30 min후행우OLV 3 h，C조TLV 30 min후계속TLV 3 h。삼조우TLV 30 min（T0）화OLV 10 min（T1）、30 min（T2）、60 min（T3）、120 min （T4）、180 min（T5）시추취동맥혈행혈기분석병계산양합지수（OI）。고동맥치관감측혈압（ABP）、심솔（HR），기록기도봉압（P peak ）。각조실험결속후처사동물，취쌍측폐조직행폐병리조직학손상평분，병측량쌍측폐조직균장액중초양화물기화매（SOD）화병이철（MDA）함량。결과여H조비교，L조동맥양분압（PaO2）재T4、T5시명현강저，동맥양포화도（SaO2）재T5시명현강저， T5시SOD함량명현증고，MDA함량명현강저，폐손상평분강저（P＜0.05）；H조경하폐포강내가견대량홍세포삼출，L조경하가견교소적염성세포침윤、폐포삼출액、폐포간질파배。결론 OLV시강저FiO 2도60%수연증가저양혈증적발생솔，단능현저감경토폐손상，저가능여감경료폐조직양화응격수평유관。
ObjectiveTo investigate the effect of different fraction of inspired oxygen (FiO2) on rabbit lung injury duringone lung ventilation (OLV).MethodsThirty healthy New Zealand rabbits weighing 1.9-2.4 kg were randomly divided into 3 groups on average: 60% O2group (group L), 100% O2 group (group H) and two lung ventilation (TLV) group was kept as control (group C, 60% O2). While group H and L underwent TLV at the first 30 min and then turned to OLV for another 3 h, group C kept TLV during the whole procedure. Arterial blood samples were collected at T0(30 min of TLV), T1(10 min of OLV), T2(30 min of OLV), T3(60 min of OLV), T4(120 min of OLV) and T5(180 min of OLV) for gas analysis. ABP and HR were monitored though femoral artery catheter, Ppeak was recorded continuously. Lung tissue samples were obtained after 3 h of OLV, the lung injury score (LIS) was recorded and the concentrations of SOD and MDA of lung tissue homogenates were measured.ResultsCompared with group H, PaO2 decreased significantly at T4 and T5, SaO2 decreased at T5 in group L (P<0.05). MDA level decreased significantly, SOD activity increased significantly, the LIS decreased significantly in group L at 3 h of OLV (P<0.05). Qualitative histological analysis of the lung tissue revealed that: there were more red blood cells in group H, while less alveolar wall thickening and polymorphonuclear infiltrates in group L. Conclusion Decreasing FiO2 to 60% increased the incidence of hypoxemia during OLV, howeverit can be helpful to reduce the lung injury in rabbits, which may be associated with lower FiO2decreasing the oxidative stress response.