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目的 探讨含氯胺酮的肺表面活性物质剂（ＰＳ）对洗肺鼠呼吸衰竭的作用。方法２０只Ｗｉｓｔａｒ大鼠经戊巴比妥钠腹腔内麻醉后，经气管切开孔插入导管行人工呼吸。吸气峰压（ＰＩＰ）定为１．４７ｋＰａ，呼吸比为１：１。将ＰＩＰ及呼气终末正压（ＰＥＥＰ）分别调至１．９６ｋＰａ和０．４９ｋＰａ后对所有动物行全肺灌洗（３７℃生理盐水，４０ｍｌ·ｋｇ－１）８～１０次。当动脉血氧分压（ＰａＯ２）降至１２ｋＰａ以下时，将动物随机分为Ａ组及Ｂ组，每组各１０例。Ａ组的动物经气管注入单纯的ＰＳ２５ｍｇ（０．５ｍｌ）；Ｂ组则注入含有氰胺酮２．５ｍｇ、ＰＳ２５ｍｇ（０．５ｍｌ），１２０ｍｉｎ后撤离ＰＥＥＰ，并将ＰＩＰ调至１．４ｋＰａ。结果所有动物的ＰａＯ２经肺灌洗后由５９．４ｋＰａ降至１０．３ｋＰａ左右（Ｐ＜０．０５）。治疗后两组的ＰａＯ２均明显升高至肺灌洗前水平（５６．３ｋＰａ）（Ｐ＜０．０５）。当撤离ＰＥＥＰ后，与灌洗前相比，Ａ组的ＰａＯ２明显下降至２０ｋＰａ以下（Ｐ＜０．０５），而Ｂ组的则保持在４６ｋＰａ以上（Ｐ＞０．０５）。至实验结束时，Ｂ组的动物全部存活，而Ａ组只有４例存活。结论含氯胺酮的肺表面活性物质剂能较好地维持无ＰＥＥＰ的低气
Objective To investigate the effect of ketamine-containing pulmonary surfactant (PS) on respiratory failure in lungs of rats. Methods Twenty Wistar rats were intraperitoneally anesthetized with sodium pentobarbital and then inserted into the catheter via tracheotomy for artificial respiration. Peak inspiratory pressure (PIP) is set at 1.47kPa, breathing ratio of 1: 1. Pulmonary perfusion (37 ℃ saline, 40ml · kg-1) for 8 ~ 10 times was performed on all animals after the PIP and PEEP were adjusted to 1.96kPa and 0.49kPa, respectively. When the arterial partial pressure of oxygen (PaO2) dropped below 12kPa, the animals were randomly divided into group A and group B, 10 in each group. Group A animals were injected with pure PS25mg (0.5ml) via the trachea. Group B was injected with 2.5mg of paclitaxel and 25ml of PS (0.5ml). After 120min, PEEP was evacuated and the PIP was adjusted to 1.4kPa. Results PaO2 of all animals decreased from 59.4 kPa to 10.3 kPa after lavage (P <0.05). After treatment, the PaO2 in both groups increased significantly to the level before lung lavage (56.3 kPa) (P <0.05). After evacuation of PEEP, PaO2 in group A decreased significantly below 20kPa (P <0.05) compared with that before lavage, whereas in group B the PaO2 remained above 46kPa (P> 0.05). By the end of the experiment, all animals in group B survived whereas only four in group A survived. Conclusions Ketamine-containing pulmonary surfactant is better at maintaining the absence of PEEP