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目的:应用大潮气量机械通气探讨制作兔的呼吸机相关肺损伤模型的最佳潮气量。方法:根据黄金分割法原理,采用三种不同潮气量68mL/kg、60mL/kg和45mL/kg各持续通气1分钟造成兔的急性肺损伤,取0h,12h,24h,48h四个时间点进行观察,观察兔存活情况,计算各时间点肺湿/干重比观察肺水肿严重程度及变化,组织病理学切片观察各时间点肺组织形态学改变。结果:1、潮气量68mL/kg组、60mL/kg组和45mL/kg组兔48h存活率分别为58.33%(7/12)、91.67%(11/12)和100%(12/12);与正常对照组相比,三组肺湿/干重比在0小时无明显变化,12小时明显增高,在24小时时达峰值,48小时后降低。3、镜下观察机械通气后不同时间肺组织均有不同程度形态学改变,68mL/kg组肺组织形态学改变非常明显,60mL/kg组肺组织形态学改变明显,45mL/kg组肺组织形态学改变不明显。结论:大潮气量通气成功建立兔的呼吸机相关肺损伤实验动物模型,潮气量指标为60mL/kg。
Objective: To explore the best tidal volume of rabbit model of ventilator-associated lung injury with large tidal volume ventilation. Methods: According to the principle of golden section, acute lung injury was induced by three different tidal volumes of 68 mL / kg, 60 mL / kg and 45 mL / kg for 1 minute respectively. Four hours after 0h, 12h, 24h, 48h The survival of rabbits was observed. The severity of pulmonary edema and changes of lung edema were observed at different time points. The histopathological sections were used to observe the morphological changes of lung tissues. The 48 h survival rate of 68 mL / kg group, 60 mL / kg group and 45 mL / kg group were 58.33% (7/12), 91.67% (11/12) and 100% (12/12), respectively. Compared with the normal control group, the lung wet / dry weight ratio of the three groups had no significant change at 0h, increased significantly at 12h, peaked at 24h and decreased after 48h. The morphological changes of lung tissue were observed at different time after mechanical ventilation. The morphological changes of lung tissue in 68mL / kg group were obvious. The morphology of lung tissue in 60mL / kg group changed obviously. The lung morphology in 45mL / kg group Change is not obvious. CONCLUSION: The experimental animal model of rabbit lung injury related to ventilator was established successfully with large tidal volume ventilation. The tidal volume index was 60 mL / kg.