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The effect of body position changes on lung function,lung CT imaging and pathology in an oleic acid-induced acute lung injury model
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES
- Issue:
- 1
- DOI:
- 10.3760/j:issn:1001-0939.2005.01.010
- Key Word:
- 肺损伤,急性;俯卧位;旋转;体层摄影术,X线计算机;病理学
Abstract： 目的通过观察不同体位下急性肺损伤(ALI)肺的氧合功能、呼吸力学、肺CT以及病理等的变化,来探讨不同体位的效应和可能机制.方法采用油酸型ALI兔模型,分为正常对照组(Ⅰ组)、仰卧位油酸组(Ⅱ组)、俯卧位油酸组(Ⅲ组)、旋转体位油酸组(Ⅳ组),观察各组兔实验过程中动脉血氧分压(PaO2)、呼吸力学的变化.并进行肺CT扫描加以分析,最后作病理切片检查.结果Ⅲ、Ⅳ组的PaO2[(158±51)、(166±37)mm Hg]、肺的顺应性[(2.8±0.9)、(2.6±0.7)ml/cm H2O]显著高于Ⅱ组[PaO2(87±24)mm Hg、肺的顺应性(1.6±0.5)ml/cm H2O,P均＜0.05];Ⅲ、Ⅳ组肺内分流[(21±5)%、(18±5)%]显著低于Ⅱ组[(29±8)%,P<0.05];Ⅳ组的气道峰压[(20±2)cm H2O]显著高于Ⅲ组[(16±2)cm H2O,P<0.05];3个实验组的PaO2与肺的顺应性呈显著正相关,与肺内分流呈显著负相关.ALI兔肺CT呈明显的重力依赖效应,体位的变化对肺CT的影响非常迅速.肺水肿在重力依赖区重,旋转后,重力依赖现象减轻.结论俯卧位和旋转体位都能改善兔油酸型ALI肺的氧合;ALI肺出现重力压迫性肺不张,旋转体位能减轻肺不张的程度和使肺水肿趋于均匀.
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