摘要
目的 观察高频喷射通气（ＨＦＪＶ）对海水淹溺肺水肿（ＰＥ－ＳＷＤ）兔血气指标和前列腺素的影响，探讨ＨＦＪＶ的治疗机制。方法 应用血气酸碱分析仪和ＸＨ－６０１０ 型γ放射免疫测定仪，对兔动脉血气酸碱６项指标和前列腺素２ 项参数进行自动检测和定量测量。结果 ＨＦＪＶ组ＰａＯ２ 、血氧饱和度（ＳＯ２ ）、ｐＨ、实际碳酸氢盐（ＡＢ）、碱剩余（ＢＥ）、和６－酮－前列腺素Ｆ１α（６－ｋｅｔｏ－ＰＧＦ１α）均比ＰＥ－ＳＷＤ组明显升高（Ｐ＜ ０．０１ 或Ｐ＜ ０．０５），ＨＦＪＶ组血栓素Ｂ２（ＴＸＢ２ ）在灌海水后３０ 分钟迅速上升随后呈下降趋势。但每项指标均未能恢复到灌海水前的水平。ＰａＣＯ２ 两组之间无显著性差异。结论 ＨＦＪＶ能较好地改善低氧血症，提高血中６－ｋｅｔｏ－ＰＧＦ１α浓度，而高浓度６－ｋｅｔｏ－ＰＧＦ１α具有支气管平滑肌松弛效应，对ＰａＯ２ 的回升有促进作用。
Objective To observe and explore the effects and therapeutic mechanism of HFJV on blood gas indexes and prostaglandin in rabbits with PE SWD. Methods Six blood gas and acid base indexes and 2 prostaglandin derivatives(TXB 2,6 keto PGF 1α ) were assayed by blood gas analyser and XH 6010 automatic gama radio immunity analyser. Results PaO 2,oxygen saturation(SO 2), pH, actual bicarbonate(AB), base excess(BE) and 6 keto PGF 1α in HFJV group were remarkably higher than in the control group without HFJV( P <0 01 or P <0 05). In HFJV group, the TXB 2 rapidly increased at 30 min after pulmonary seawater infusion and then lowered, but still not recovered to pre infusion normal level. There was no significant difference of PaCO 2 between the PE SWD groups with and without HFJV. Conclusions HFJV therapy may improve hypoxemic condition and increase the blood concentration of 6 keto PGF 1α . The high concentration of blood 6 keto PGF 1α could produce relaxing effect on smooth muscle of the bronchus and help to raise PaO 2 level.
关键词
高频喷射通气
肺水肿
海水淹溺
血气分析
High frequency jet ventilation Pulmonary edema Seawater drowning Blood gas analysis Prostaglandins Hypoxemia
