CAJ | 학술논문

目的：探讨建立自主呼吸麻醉下兔单肺呼吸实验模型的方法。方法健康雄性新西兰大白兔共10只，将戊巴比妥配成1%的溶液，按3 mL/kg(30 mg/kg)于兔耳缘静脉缓慢注射进行诱导麻醉。予以自制面罩辅助给氧(氧流量4 mL/h)。右侧卧位后经左第6肋间开一大小约1 cm×1 cm切口观察肺萎陷情况，以左肺通气膨胀到萎陷为单肺呼吸模型建立成功。单肺呼吸2h后，缝合胸壁后通过注射器抽取胸腔内气体实施肺复张。分别于单肺呼吸前(T0)、单肺呼吸30 min(T1)、单肺呼吸2 h(T2)和恢复双肺呼吸30 min(T3)4个时间点记录兔的心率、动脉压和动脉血气分析结果。结果实验中兔的血流动力学稳定，各时间点心率、平均动脉血压比较，差异均无统计学意义(P>0.05)。与T0时点比较，T2时点的pH显著降低(P<0.05)，其余时点间pH差异均无统计学意义(P>0.05)。各时点间动脉血二氧化碳分压差异均无统计学意义(P>0.05)。与T0时点比较，T1和T2时点的动脉氧分压均显著降低(P<0.05)；与T1时点比较，T3时点的动脉氧分压显著升高(P<0.05)；与T2时点比较，T3时点的动脉氧分压显著升高(P<0.05)。自主呼吸状态下麻醉效果良好，而且操作方便，各时点动脉血气变化规律与临床一致。结论通过自制吸氧面罩可以建立新西兰大白兔自主呼吸麻醉下单肺呼吸模型。此模型简单方便，费用低，成功率高，适用于研究自主呼吸麻醉下相关的肺和远隔器官损伤病理生理机制。
목적：탐토건립자주호흡마취하토단폐호흡실험모형적방법。방법건강웅성신서란대백토공10지，장무파비타배성1%적용액，안3 mL/kg(30 mg/kg)우토이연정맥완만주사진행유도마취。여이자제면조보조급양(양류량4 mL/h)。우측와위후경좌제6륵간개일대소약1 cm×1 cm절구관찰폐위함정황，이좌폐통기팽창도위함위단폐호흡모형건립성공。단폐호흡2h후，봉합흉벽후통과주사기추취흉강내기체실시폐복장。분별우단폐호흡전(T0)、단폐호흡30 min(T1)、단폐호흡2 h(T2)화회복쌍폐호흡30 min(T3)4개시간점기록토적심솔、동맥압화동맥혈기분석결과。결과실험중토적혈류동역학은정，각시간점심솔、평균동맥혈압비교，차이균무통계학의의(P>0.05)。여T0시점비교，T2시점적pH현저강저(P<0.05)，기여시점간pH차이균무통계학의의(P>0.05)。각시점간동맥혈이양화탄분압차이균무통계학의의(P>0.05)。여T0시점비교，T1화T2시점적동맥양분압균현저강저(P<0.05)；여T1시점비교，T3시점적동맥양분압현저승고(P<0.05)；여T2시점비교，T3시점적동맥양분압현저승고(P<0.05)。자주호흡상태하마취효과량호，이차조작방편，각시점동맥혈기변화규률여림상일치。결론통과자제흡양면조가이건립신서란대백토자주호흡마취하단폐호흡모형。차모형간단방편，비용저，성공솔고，괄용우연구자주호흡마취하상관적폐화원격기관손상병리생리궤제。
Objective To build an experimental model of one-lung respiration model in rabbits under spontaneous res-piration anesthesia. Methods Ten healthy New Zealand white rabbits were anesthetized with 1% sodium pentobarbital 3 mL/kg (30 mg/kg) intravenously administered through the ear vein. A homemade oxygen mask was cover the nose and mouth with 4 mL/h oxygen was used during the study. After the rabbits were fixed to right lateral position, the sixth of left intercostal space was opened a small incision (1 cmí1 cm) to observe the lung collapse. The spontaneous respira-tion model was successfully established according to the left lung from expansion to collapse. Heart rate, mean arterial pressure and arterial blood gases were recorded in four phases: before thoracic surgery (T0), 30 min after operation (T1), 2 hours after operation (T2) and 30 minutes after returning to two-lung spontaneous respiration (T3). Results The hemo-dynamic was stable in the experiment. Effective of rabbit model under spontaneous respiration anesthesia was satisfac-tory, safety and convenient. HR and MAP at different time point had no significant difference (P> 0.05). Further anal-ysis of blood gas, the results showed that the comparison of T0, pH at T2 was significant lower (P<0.05), the other ob-servations of pH at different time point had no statistical difference (P>0.05), PaCO2 of each group had no difference at different time point (P > 0.05). Compared with T0, PaO2 was significantly lower than that at T1 and T2 (P<0.05). Compared with T1, PaO2 was significantly higher than that at T3 (P< 0.05). Compared with T2, PaO2 was significantly higher than that at T3 (P < 0.05); the changes of arterial blood in each phase gases were sim-ilar to clinical. Conclusion The rabbit model of spontaneous respiration is easy to perform with self-made oxygen mask and can reduce the spending of animals and equipments. This model is suitable for the investigation of the pathophysi-ological mechanism in lung and remote organ injury induced by spontaneous respiration anesthesia.