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目的 :观察酸滴入侧的急性肺损伤 (AL I)的形成及对侧肺有无损伤形成。方法 :18只新西兰兔随机分为生理盐水 (NS)滴入对照组和盐酸滴入损伤组。以向右肺内滴入 NS或 HCl后的血气、气道压力、动静态顺应性、肺湿 /干比 (W/ D)和支气管肺泡灌洗液 (BAL F)中总蛋白 (TP)、总磷脂 (TPL )、饱和磷脂占总磷脂比(DSPC/ TPL )及肺组织形态学来判断有无 AL I及其严重程度。结果 :损伤组在酸滴入后 Pa O2 较基础值和对照组显著下降而 Pa CO2 显著上升 ,损伤组气道压力显著高于基础值和对照组。损伤组右肺的 W/ D和 TP均高于对照组右肺 ,而 TPL 和 DSPC/ TPL 则低于对照组 ,2组左肺的上述各参数相比均无显著性差异。损伤组右肺病理损伤明显 ,而损伤组左肺和对照组双肺镜下未见异常。结论 :(1)酸滴入后肺内可形成弥漫性的以蛋白通透性肺水肿为特征的急性炎性损伤。 (2 )单侧肺滴入酸未导致对侧肺形成 AL I
OBJECTIVE: To observe the formation of acute lung injury (ALI) on the acid dripping side and whether there is damage to the contralateral lung. Methods: Eighteen New Zealand rabbits were randomly divided into normal saline (NS) instilled into control group and hydrochloric acid drip into injury group. Blood gas, airway pressure, dynamic and static compliance, lung wet / dry ratio (W / D), and total protein (TP) in bronchoalveolar lavage fluid (BALF) Total lipids (TPL), total phospholipids (DSPC / TPL), and lung histomorphology to determine the presence or absence of AL I and its severity. Results: After the acid instillation PaO2 decreased significantly and PaCO2 significantly increased in injured group compared with baseline and control group. The airway pressure in injured group was significantly higher than that of baseline and control group. W / D and TP in the right lung of the injury group were higher than those in the right lung of the control group, but TPL and DSPC / TPL were lower than those in the control group. There was no significant difference in the above parameters between the two groups. The pathological damage of the right lung in the injury group was obvious, while the left lung in the injury group and the control group showed no abnormalities in both lungs. CONCLUSION: (1) Acute inflammatory injury characterized by protein-permeable pulmonary edema may be formed diffusely in the lung after acid instillation. (2) unilateral lung drip acid did not lead to the contralateral lung formation ALI