摘要
目的探讨高渗氯化钠对单肺通气患者的病理学影响。方法选择拟单肺通气剖胸手术ASAⅠ～Ⅱ级的患者60例,随机分为高渗氯化钠治疗组(H组)和对照组(C组),每组30例。在单肺通气30 min时经中心静脉导管输注7.5%氯化钠溶液(H组)或生理盐水(C组)2 mL/kg。观察开始进行单肺通气(T1)、单肺通气30 min(T2)、输注完成后30 min(T3)、输注后60 min(T4)、单肺通气结束(T5)5个时点的动态肺顺应性(Cdyn)、气道峰压(Ppeak)、气道平均压(Pmean)、动脉血氧分压(p(O2))、血清Na+浓度,并于T1、T5时各取肺组织1块,切片染色高倍镜下观察。结果 2组患者T1与T2时间段比较,Cdyn、p(O2)明显降低,Ppeak、Pmean明显升高。H组T3、T4、T5与T2比较,Cdyn、p(O2)逐渐升高,Ppeak、Pmean逐渐下降,且H组T3、T4、T5的Cdyn、p(O2)明显高于C组,Ppeak明显低于C组,H组T4、T5的Pmean明显低于C组。而C组患者T3、T4、T5的Cdyn、Ppeak、Pmean、p(O2)与T2比较无显著性差异。切片观察到H组出现肺组织病理学改变的明显少于C组。结论 7.5%氯化钠溶液对单肺通气患者的各呼吸力学参数有改善作用,能明显减少肺组织损伤,对肺通气功能具有保护作用。
Objective It is to explore the effect of hypertonic sodium chloride on pathology in. Methods 60 patients with ASA Ⅰ - Ⅱ level undergoing one-lung ventilation thoracotomy were randomly divided into hypertonic saline treatment group （group H） and control group （group C） , 30 eases in each one. In the first one-lung ventilation via central venous catheter at 30 min infusion of 7.5% sodium chloride solution （ group H） or saline （group C） 2 mL/kg. Dynamic lung compliance （Cdyn） , peak airway pressure （Ppeak） , mean airway pressure （Pmean） , arterial oxygen pressure （p（ O2 ）） , serum Na ＋ concentration were observed at five points in time which were begin one-lung ventilation （ T1 ）, one-lung ventilation section 30 min （ T2 ） , after the first infusion 30 min （ T3 ） , after infusion 60 min （ T4 ） , the end of one-lung ventilation （ T5 ） , and in T1, T5 lung tissue from each piece of stained sections were observed under high-powered microscope. Results Cdyn, p（ O2 ） decreased and Ppeak, Pmean significantly increased at T1 and T2 in both groups（P 〈0.05）. Cdyn, p（ O2 ） increased gradually and Ppeak, Pmean significantly decreased at T3, T4 and T5 compared with that at T2 in group H, and Cdyn, p（ O2 ） were obviously higher and Ppeak was significantly lower at T3 , T4 and T5 in group H compared with that in group C. Pmean was lower at T4 and T5 in group H than that in group C. Compared with that at T2, no significant difference in Cdyn, Ppeak, Pmean, p（O2） at T3, T4 and Ts in group C was found. Pathology changes of lung tissue in group H were less than that in group C. Conclusion 7.5% sodium chloride solution has improving effect on various respiratory mechanics parameters in onelung ventilation patients, and can significantly reduce lung injury and has protective function on pulmonary function.
出处
《现代中西医结合杂志》
CAS
2012年第31期3427-3428,3431,共3页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
高渗氯化钠
单肺通气
病理学
hypertonic sodium chloride
one-lung ventilation
pathology
