中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
24期
4440-4443
,共4页
闫丹丹%张丹%李燕东%张岚%孟焱%翟林%邢锦
閆丹丹%張丹%李燕東%張嵐%孟焱%翟林%邢錦
염단단%장단%리연동%장람%맹염%적림%형금
兔%模型,动物%胸部超声%彗星尾征%急性肺损伤/急性呼吸窘迫综合征
兔%模型,動物%胸部超聲%彗星尾徵%急性肺損傷/急性呼吸窘迫綜閤徵
토%모형,동물%흉부초성%혜성미정%급성폐손상/급성호흡군박종합정
Rabbits%Models,animal%Chest ultrasound%Comet-tail sign%Acute lung injury/acute respiratory distress syndrome
目的：建立油酸型急性肺损伤动物模型，探讨胸部弥漫性彗星尾征的临床价值。方法雌性日本大耳白兔19只，1 ml/kg 3%戊巴比妥钠经耳缘静脉麻醉后仰卧位固定于兔台，胸部备皮。将双侧前胸壁分为上、下肺区，共四区；经胸部超声检查留取四区的正常胸部声像图。按0.1 ml/kg油酸经耳缘静脉一次性注入后即开始计时，动态观察四个肺区的彗星尾征出现的时间、数量，并存储图像，直至1 h结束。结果18只家兔出现胸部弥漫性彗星尾征，模型制作成功率为94.7%。注入油酸后，胸部声像图为短小彗星尾征、孤立彗星尾征、轻度弥漫性彗星尾征、中度弥漫性彗星尾征、重度弥漫性彗星尾征（瀑布征），出现的时间为：（5.36±2.16）min，（7.11±2.67）min，（10.94±5.94）min，（28.64±12.04）min，（46.40±5.59）min；短小彗星尾征是急性肺损伤最早出现的声像图表现。至1h观察结束时，上肺区主要表现为轻度弥漫性彗星尾征，下肺区主要表现为中度弥漫性彗星尾征。结论0.1 ml/kg油酸经耳缘静脉一次性注射即可快速复制家兔胸部弥漫性彗星尾征模型；模型成功的标志为注入油酸1h内出现弥漫性彗星尾征；短小彗星尾征是急性肺损伤最早出现的声像图表现，可作为提示急性肺损伤的早期声像图指征，为临床及早预防急性肺损伤提供重要参考价值。
目的：建立油痠型急性肺損傷動物模型，探討胸部瀰漫性彗星尾徵的臨床價值。方法雌性日本大耳白兔19隻，1 ml/kg 3%戊巴比妥鈉經耳緣靜脈痳醉後仰臥位固定于兔檯，胸部備皮。將雙側前胸壁分為上、下肺區，共四區；經胸部超聲檢查留取四區的正常胸部聲像圖。按0.1 ml/kg油痠經耳緣靜脈一次性註入後即開始計時，動態觀察四箇肺區的彗星尾徵齣現的時間、數量，併存儲圖像，直至1 h結束。結果18隻傢兔齣現胸部瀰漫性彗星尾徵，模型製作成功率為94.7%。註入油痠後，胸部聲像圖為短小彗星尾徵、孤立彗星尾徵、輕度瀰漫性彗星尾徵、中度瀰漫性彗星尾徵、重度瀰漫性彗星尾徵（瀑佈徵），齣現的時間為：（5.36±2.16）min，（7.11±2.67）min，（10.94±5.94）min，（28.64±12.04）min，（46.40±5.59）min；短小彗星尾徵是急性肺損傷最早齣現的聲像圖錶現。至1h觀察結束時，上肺區主要錶現為輕度瀰漫性彗星尾徵，下肺區主要錶現為中度瀰漫性彗星尾徵。結論0.1 ml/kg油痠經耳緣靜脈一次性註射即可快速複製傢兔胸部瀰漫性彗星尾徵模型；模型成功的標誌為註入油痠1h內齣現瀰漫性彗星尾徵；短小彗星尾徵是急性肺損傷最早齣現的聲像圖錶現，可作為提示急性肺損傷的早期聲像圖指徵，為臨床及早預防急性肺損傷提供重要參攷價值。
목적：건립유산형급성폐손상동물모형，탐토흉부미만성혜성미정적림상개치。방법자성일본대이백토19지，1 ml/kg 3%무파비타납경이연정맥마취후앙와위고정우토태，흉부비피。장쌍측전흉벽분위상、하폐구，공사구；경흉부초성검사류취사구적정상흉부성상도。안0.1 ml/kg유산경이연정맥일차성주입후즉개시계시，동태관찰사개폐구적혜성미정출현적시간、수량，병존저도상，직지1 h결속。결과18지가토출현흉부미만성혜성미정，모형제작성공솔위94.7%。주입유산후，흉부성상도위단소혜성미정、고립혜성미정、경도미만성혜성미정、중도미만성혜성미정、중도미만성혜성미정（폭포정），출현적시간위：（5.36±2.16）min，（7.11±2.67）min，（10.94±5.94）min，（28.64±12.04）min，（46.40±5.59）min；단소혜성미정시급성폐손상최조출현적성상도표현。지1h관찰결속시，상폐구주요표현위경도미만성혜성미정，하폐구주요표현위중도미만성혜성미정。결론0.1 ml/kg유산경이연정맥일차성주사즉가쾌속복제가토흉부미만성혜성미정모형；모형성공적표지위주입유산1h내출현미만성혜성미정；단소혜성미정시급성폐손상최조출현적성상도표현，가작위제시급성폐손상적조기성상도지정，위림상급조예방급성폐손상제공중요삼고개치。
Objective To establish oleic acid acute lung injury animal model and investigate clinical value of chest diffuse comet-tail sign. Methods Nineteen adult female Japanese big ear rabbits were anesthetized via ear marginal vein (1 ml/kg 3%sodium pentobarbital) and fixed on the rabbit platform in supine position, then the chest skin preparation was operated. The bilateral anterior chest wall were divided into upper and lower lung zone, a total of four regions. Transthoracic ultrasound taked normal chest ultrasonography of the four regions. 0.1 ml/kg oleic acid were injected disposable via ear marginal vein, the observer started timing, observed dynamic time and quantity about comet-tail sign of the four lung regions and stored images until 1 hour. Results 18 rabbits occurred chest diffuse comet-tail sign, the success rate of model making was 94.7%. After the injection of oleic acid, chest ultrasonography:short comet-tail sign, isolated comet-tail sign, mild diffuse comet-tail sign, moderate diffuse comet-tail sign and severe diffuse comet-tail sign (falls sign), the time they appear: (5.36±2.16)min, (7.11±2.67)min, (10.94±5.94)min, (28.64±12.04)min, (46.40±5.59)min. Short comet-tail sign is the most early sonographic manifestation of acute lung injury. Until the end of 1 hour, upper lung region was characterized by mild diffuse comet-tail sign, lower lung region was characterized by moderate diffuse-comet tail sign. Conclusions The injection of 0.1ml/kg oleic acid via ear marginal vein can rapidly replicate chest diffuse comet-tail sign model in rabbits, appearance of diffuse comet-tail sign in an hour after injection of oleic acid mean model’s success. Short comet-tail sign is the most early sonographic manifestation of acute lung injury, can be used as the early sonographic signs prompting acute lung injury, and provide important reference value for the clinical prevention of acute lung injury.
