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目的:比较单独或联合应用气道滴入肺表面活性物质(Surf)和吸入一氧化氮(iNO)对急性呼吸窘迫综合征的疗效。方法:成年兔反复气道生理盐水灌洗,去除内源Surf,经机械通气诱发急性肺损伤和呼吸衰竭,随机分组给予:iNO 0.8μmol·L~(-1);Surf磷脂100mg·kg~(-1);联合应用iNO和Surf;或不给药对照。结果:机械通气8小时生存率以联合治疗组为最高,Surf组及联合治疗组的氧合指数(OI)、肺顺应性、气道阻力均有所改善。联合治疗组的肺膨胀有显著改善。结论:对因Surf缺乏而萎陷和损伤的肺,单纯iNO不显治疗效果,但应用Surf或与iNO联合应用,具有提高生存率和改善血氧及肺膨胀的效果。
OBJECTIVE: To compare the efficacy of airway instillation of airway surfactant (NO) and inhaled nitric oxide (NO) alone or in combination on acute respiratory distress syndrome. Methods: Adult rabbits were infused repeatedly with normal saline to remove endogenous Surf. After mechanical ventilation, acute lung injury and respiratory failure were induced and randomly divided into groups: iNO 0.8μmol·L -1; Surf phospholipid 100mg · kg ~ (-1) -1); iNO and Surf combined; or no control. Results: The survival rate of 8-hour mechanical ventilation was the highest in the combination therapy group. The oxygenation index (OI), lung compliance and airway resistance of the Surf group and the combination group were all improved. Lung expansion in the combination therapy group was significantly improved. CONCLUSIONS: Lungs that are collapsed and damaged due to lack of Surf are not treated with iNO alone. However, the combination of Surf or iNO has the potential to improve survival and improve blood oxygenation and lung expansion.