摘要
目的：观察综合治疗海水淹溺肺水肿（ＰＥ ＳＷＤ）兔的肺形态结构变化并探讨作用机制。方法：用海水灌注的方法制作ＰＥ ＳＷＤ模型，分别采用高频喷射通气（ＨＦＪＶ）联合４ 种药物治疗、一氧化氮（ＮＯ）治疗和高压氧（ＨＢＯ）治疗，观察经３种综合实验治疗后兔肺形态结构变化，并用Ｃａ２＋ 超微结构方法观察兔肺细胞内Ｃａ２＋ 变化。结果：３组治疗措施均能明显减轻肺水肿病变，且能明显缓解细胞内Ｃａ２＋ 超负荷状况，其中ＨＢＯ治疗效果最好，ＮＯ治疗效果次之〔模型组Ｃａ２＋ 沉淀反应颗粒为（１１２．８０±１１．３６）个／μｍ ２ ，ＨＢＯ 组降低为（４７．７０±１１．３９）个／μｍ ２，ＮＯ组降低为（７３．９０±１８．２４）个／μｍ ２，Ｐ均＜ ０．０１〕。结论：ＨＦＪＶ联合４种药物治疗是行之有效的治疗措施，可作为ＰＥ ＳＷＤ的基础治疗，条件许可时应尽量加用ＮＯ吸入或ＨＢＯ治疗。
Objective:To observe the pathological changes in pulmonary edema of seawater drowning(PESWD) lungs in rabbits treated with comprehensive methods and explore their mechanisms.Methods:PESWD was produced by introducing seawater into the rabbit′s lungs.44 rabbits were divided randomly into PESWD control group and three treatment groups,including animals treated with high frequency jet ventilation (HFJV) combined with four drugs,nitric oxide (NO) inhalation,and hyperbaric oxygen therapy (HBO).Pathological changes and Ca 2+ in the lung cells were measured and analysed by ultrastructural methods.Results:These treatment modalities were useful in reducing pulmonary edema and Ca 2+ inflow.It has also been found that HFJV combined with drugs could obviously reduce the damage of PESWD and the Ca 2+ inflow to cells.The count of the reaction products of Ca 2+ was (112 80±11 36)/μm 2 in PESWD group,(47 70± 11 39)/μm 2 in HBO group and (73 90±18 24)/μm 2 in NO group (all P <0 01).Conclusions:HFJV combined with drugs is one of the useful methods for PESWD treatment.However,HBO therapy is the best choice.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第1期7-9,共3页
Chinese Critical Care Medicine
基金
全军"九五"医药卫生科研基金!资助项目(96M 036)
关键词
肺水肿
海水淹溺
高频喷射通气
一氧化氮
治疗
pulmonary edema
seawater drowning
high frequency jet ventilation
nitric oxide
hyperbaric oxygen
calcium ions
