摘要
作者观察了犬体表烧伤早期肺功能和肺血流动力学及肺形态学改变。结果表明:犬体表烧伤后呼吸频率加快,气道阻力增大,肺顺应性和肺阻抗Z_0减小,PaO_2和PaCO_2降低;肺动脉压和肺动脉楔嵌压升高,肺循环血管阻力增大;肺组织光镜和电镜检查可见肺间质和肺泡水肿、出血,肺实质白细胞浸润,肺小血管微血栓形成。证实严重体表烧伤休克期可发生呼吸窘迫综合征样肺损伤病变。文中对这种肺损伤的特点进行了讨论。
This study investigated the pulmonary and hemodynamie dysfunction and morphologic (上接240页) changes after major barns. Full-thickaess b.trns, 40% TBSA. were produced in 9 dogs. Respiratory Rate (RR), airway resistance (Raw),effective compliance (Ec), lung impedance Zo (LIZo), pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure(PAWP), blood gas monitoring, light and electron microscopic studies were Herformed. Following barns, RR, Raw,PAP and PAWP increased and Ec, LIZo, RaCO_2 and PaO_2 decreased significantly while morphologic evidence of endothelial and interstitial edema was associated with significant cellular infiltration of lung tissue, especially by leukoyytes, showing evidence of degranulation. This results shown that a 40% TBSA. burn without inhalation injury can produc elung injury similarly to adult respiraGory distss ess syndrome. This lung injury is characterized by inereasingpulmonary capilary permeability. Ec and LIZo monitoring may help to early diagnose of lung injury after major burns.
