摘要
目的观察低温气体机械通气对犬体温、呼吸力学、血气参数值及肺组织病理的影响。方法将健康雄性杂种犬18只，按随机数字表法均分为2组，即低温组（HG）和常温组（NG）。气管插管后低温组和常温组分别用4℃低温气体和25％常温气体行机械通气，犬气管插管后0min作为基础值，连续观察240rain。每30min分别观察并记录实验犬鼻咽温、腋温、血温；取机械通气0min、1、2、3、4h5个时间点分别观察并记录实验犬动脉血气[氧分压（PaO2）、二氧化碳分压（PaCO2）、酸碱度（pH）]和呼吸力学参数[气道阻力（Raw）、气道峰压（PIP）、肺静态顺应性（Cstat）]。机械通气0min、2、4h3个时间点用ELISA法测白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）浓度，最后取肺组织在光镜下观察其病理学变化。结果低温组和常温组不同通气时间的体温（鼻咽温、腋温、血温）差异无统计学意义（P〉0．05），低温组和常温组各时间点的PaO：、PaCO：、pH及Raw、Ppeak、Cstat差异均无统计学意义（P〉0．05）。在2、4h时间点的低温组和常温组IL-6水平显著高于基础值（P〈0．05），在通气2、4h时间点的低温组IL-6浓度分别为（0．292±0．024），（0．281±0．022）μg／L显著低于常温组相应时间点浓度（0-312±0．133），（0．301±0．031）μg／L；在2h时间点低温组和常温组TNF啾浓度显著高于基础值（P〈0．05），但在各时间点两组TNF-α浓度差异无统计学意义（P〉0．05）；低温组肺组织累积平均评分（2．44±1．03）显著低于常温组（4．01±1．31）。结论与常温气体机械通气相比4℃低温气体机械通气对犬的的体温、向气交换和呼吸力学没有明显的影响．但能抑制炎件因子（IL-6）的分泌．减轻肺组织病王罩损伤。
Objective To investigate the effect of mechanical ventilation with cold air on body temperature, pneodynamics, blood gas parameters and histological changes of lung tissue in dogs. Methods Eighteen healthy male dogs were randomly divided into two groups （n=9）： hypothermia group and normothermia group. The animals were ventilated with cold air （4℃） or normal air （25℃） respectively. Ventilation parameters in each group were set aS：VT=15 ml/kg, RR =15 bpm, I： E=1： 2. The body temperatures（Tnp, Tb, Ta） were recorded immediately and repeated every 30 rain until it counted to 240 min. Blood gas parameters （PaO2, PaCO2, pH） and pneodynamic parameters （Raw, Ppeak, Cstat） were measured at 0, 30 rain, 1, 2, 3 h and 4 h after intubation. Plasma cytokine （TNF-α, IL-6） concentrations at 0min, 2 h and 4 h were measured using ELISA, and histopathologic appearance of lung tissue was observed under a light microscopy. Results There were no significant differences in body temperatures between the two groups （P〉0.05）. There were no statistical significances in PaO2, PaCO2, pH, Raw, Ppeak, or Cstat values at different times between the hypothermia group and the normothermia group. Plasma IL-6 eoncentrations at 2 h and 4 h increased significantly in both groups compared with baseline values. However, concentrations of serum IL-6 at 2 h and 4 h were lower in hypothermia group compared with normothermia group[ （0.292±0.024） p,g/L vs （0.312±0.133 ） μg/L at 2 h; （0.281±0.022）μg/L vs （0.301-±0.031）μg/L at 4 h]. Plasma TNF~ concentration at 2 b increased in both groups compared with basal level. But there were no significant differences in plasma TNF-α concentration between the two groups. Cumulative mean histology scores showed lower in hypothermia group （2.44±1.03） than that in normothermia group （4.01±1.31, P〈0.05）. Conclusion Compared with normal air mechanical ventilation, cold air ventilation at 4℃ has no effect on body temperature, pneodynamies or blood-gas exchange, but it has a beneficial effect on attenuating the elevation of serum IL-6 concentration and reducing the injury of lung tissue.
出处
《国际麻醉学与复苏杂志》
CAS
2011年第6期695-699,共5页
International Journal of Anesthesiology and Resuscitation
关键词
低温气体
机械通气
犬
体温
呼吸
Cold air
Mechanical ventilation
Canine
Body temperature
Respiratory
