目的 對(duì)控制低通氣造成的低氧血癥伴高碳酸血癥家兔, 用純氧進(jìn)行腹膜腔通氣, 觀察其對(duì)動(dòng)脈血?dú)獾挠绊?。方?16 只家兔經(jīng)氣管切開并插入氣管導(dǎo)管, 連接呼吸機(jī)。調(diào)整呼吸機(jī)參數(shù), 同時(shí)使用肌肉松弛劑抑制自主呼吸, 造成低通氣, 致使兔PaO2 降低和PaCO2 升高, 制備低氧血癥伴高碳酸血癥家兔模型, 然后用純氧進(jìn)行腹膜腔內(nèi)通氣, 檢測(cè)腹膜腔內(nèi)通氣開始后0. 5、1、1. 5 及2 h動(dòng)脈血?dú)?。結(jié)果 經(jīng)純氧腹膜腔內(nèi)通氣后, PaO2 由通氣前的( 52. 50 ±3. 46) mm Hg分別顯著升至腹膜腔通氣后30 min 的( 76. 46 ±7. 79) mmHg 、1 h 的( 79. 62 ±9. 53) mm Hg、1. 5 h 的( 78. 54 ±7. 18) mm Hg、2 h的( 81. 1 ±8. 3) mmHg( P 均 lt; 0. 05) , 通氣各時(shí)點(diǎn)之間差異無統(tǒng)計(jì)學(xué)意義( P gt;0. 05) 。而PaCO2 變化不顯著( P gt;0. 05) , 由( 63. 84 ±9. 09) mmHg降至腹膜腔通氣后0. 5 h 的( 59. 84 ±14. 22 ) mm Hg、1 h 的( 59. 16 ±15. 5) mmHg、1. 5 h 的( 60. 02 ±7. 07) mm Hg、2 h 的( 61. 38 ±6. 56) mm Hg。結(jié)論 用純氧進(jìn)行腹膜腔內(nèi)通氣能明顯改善肺控制性低通氣家兔的低氧血癥, 而對(duì)高碳酸血癥改善不明顯。
引用本文： 羅志兵,沈策. 腹膜腔純氧通氣改善肺控制性低通氣家兔的低氧血癥. 中國呼吸與危重監(jiān)護(hù)雜志, 2009, 09(4): 396-398. doi: 復(fù)制
| 1. | Miyaguchi N, Nagahiro I, Kotani K, et al. Transintestinal systemic oxygenation using perfluorocarbon. Surg Today, 2006, 36: 262-266. |
| 2. | Hanly EJ, Aurora AR, Fuentes JM, et al. Abdominal insufflation with CO2 causes peritoneal acidosis independent of systemic pH. J Gastrointest Surg, 2005, 9: 1245-1251. |
| 3. | Barr J, Livne A, Lushkov G. Peritoneal ventilation: an animal model of extrapulmonary ventilation in adult respiratory distress syndrome.Pediatr Res, 1994 , 35: 682 -684. |
| 4. | Barr J, Lushkov G, Strauss S, et al. Peritoneal ventilation in rabbits:augmentation of gas exchange with cisapride. Thorax, 1996,51:82-86. |
| 5. | EudanksWS.內(nèi)鏡腹腔鏡外科學(xué). 王秋生, 譯. 北京: 北京醫(yī)藥科技出版社, 2001, 22. |
| 6. | Siriwardhana SA, Newfield AM, Lipton JM, et al. Oxygen delivery by the peritoneal route. Can J Anaesth, 1990 , 37: S159 . |
| 7. | Matsutani N, Takase B, Nogami Y, et al. The peritoneum as a novel oxygenation organ: revitalization of intraperitoneal oxygenation.Shock, 2008, 30: 250-253. |
| 8. | 朱光華, 張蔚, 宗華, 等. 經(jīng)氣管插管管壁內(nèi)導(dǎo)管吹氣聯(lián)合壓力控制通氣治療急性呼吸窘迫綜合征. 中國呼吸與危重監(jiān)護(hù)雜志, 2006, 5: 418-420. |
| 9. | 姚泰, 主編. 生理學(xué). 北京: 人民衛(wèi)生出版社, 2001, 198. |
| 10. | Shamus R, Joshua P, Atul S, et al. Peritoneal perfusion with oxygenated perfluorocarbon augments systemic oxygenation. Chest,2006, 130: 402-411. |
| 11. | 晉云, 陳訓(xùn)如. 二氧化碳?xì)飧箤?duì)呼吸循環(huán)系統(tǒng)影響研究的新進(jìn)展. 解放軍醫(yī)學(xué)雜志, 2002, 27: 647-648. |
- 1. Miyaguchi N, Nagahiro I, Kotani K, et al. Transintestinal systemic oxygenation using perfluorocarbon. Surg Today, 2006, 36: 262-266.
- 2. Hanly EJ, Aurora AR, Fuentes JM, et al. Abdominal insufflation with CO2 causes peritoneal acidosis independent of systemic pH. J Gastrointest Surg, 2005, 9: 1245-1251.
- 3. Barr J, Livne A, Lushkov G. Peritoneal ventilation: an animal model of extrapulmonary ventilation in adult respiratory distress syndrome.Pediatr Res, 1994 , 35: 682 -684.
- 4. Barr J, Lushkov G, Strauss S, et al. Peritoneal ventilation in rabbits:augmentation of gas exchange with cisapride. Thorax, 1996,51:82-86.
- 5. EudanksWS.內(nèi)鏡腹腔鏡外科學(xué). 王秋生, 譯. 北京: 北京醫(yī)藥科技出版社, 2001, 22.
- 6. Siriwardhana SA, Newfield AM, Lipton JM, et al. Oxygen delivery by the peritoneal route. Can J Anaesth, 1990 , 37: S159 .
- 7. Matsutani N, Takase B, Nogami Y, et al. The peritoneum as a novel oxygenation organ: revitalization of intraperitoneal oxygenation.Shock, 2008, 30: 250-253.
- 8. 朱光華, 張蔚, 宗華, 等. 經(jīng)氣管插管管壁內(nèi)導(dǎo)管吹氣聯(lián)合壓力控制通氣治療急性呼吸窘迫綜合征. 中國呼吸與危重監(jiān)護(hù)雜志, 2006, 5: 418-420.
- 9. 姚泰, 主編. 生理學(xué). 北京: 人民衛(wèi)生出版社, 2001, 198.
- 10. Shamus R, Joshua P, Atul S, et al. Peritoneal perfusion with oxygenated perfluorocarbon augments systemic oxygenation. Chest,2006, 130: 402-411.
- 11. 晉云, 陳訓(xùn)如. 二氧化碳?xì)飧箤?duì)呼吸循環(huán)系統(tǒng)影響研究的新進(jìn)展. 解放軍醫(yī)學(xué)雜志, 2002, 27: 647-648.