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高氧液对低氧血症防治作用的系列研究
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摘要
目的:
     1.实验部分:研究静脉输注高氧液(HO)对油酸型急性呼吸窘迫综合症(ARDS)大鼠的治疗作用并探讨其作用机制。
     2.临床部分:研究静脉输注高氧液在防治普胸术后患者低氧血症中的作用并探讨静脉液体给氧新途径。
     方法:
     1.实验部分:以林格氏液为基液制备HO,将30只大鼠随机分为油酸组(A组),高氧液组(B组)和正常对照组(C组),每组各10只。A和B组均经右股静脉注入油酸0.1mL/kg建立ARDS模型,C组动物注入等量生理盐水。B组于注射油酸30min后,经右侧股静脉给予HO(10ml/kg·h)。C组给予等量林格氏液。各组分别在ARDS模型制备前(0min)、注射油酸后30、60、120min时间点经右颈总动脉采血监测动脉血氧分压(PaO_2)、动脉血氧饱和度(SaO_2)、动脉血二氧化碳分压(PaCO_2)、血酸碱度(PH)、碱剩余(BE)、碳酸氢根离子(HCO_3~-)等血气分析指标,2h后处死动物取肺组织,测定肺组织内丙二醛(MDA)和超氧化物歧化酶(SOD)含量、肺水含量,肺体质量比值及观察其病理变化。
     2.临床部分:选择普胸手术患者40例,随机分为对照组(A组:输注普通平衡盐液)和高氧液治疗组(B组:输注高氧平衡盐液),每组均在全麻术后拔出气管导管10min后输入液体,各组用药速率均为10ml/kg·h。在输入前、输液进行中2h,输液完毕后2h监测动脉血气,同时观察患者末梢血氧饱和度(SaO_2)、心率(HR)、呼吸频率(RR)、血压(BP)等指标变化以及观察有无不良反应。
Objective
    1. To investigate the effects of intravenous hyperoxia solution (HO) on oleic acid induced ARDS rats.
    2. To study preventive effects of intravenous hyperoxia solution on hypoxemia after ordinary thoracic operation.
    Methods
    1. HO was prepared from Ringers solution. Thirty rats were randomly divided into three groups: Oleic acid group (group A), HO treatment group (group B) and control group (group C) with 10 in each group. ARDS model was established by iv oleic acid (0.1 mL / kg) in group A and group B, while in group C, the same volume of normal saline was given. At 30 min after oleic acid administration, HO(10ml/kg · h) was applied in group B, which was replaced by Ringers solution in group A and group C. Blood samples were taken for blood-gas analysis before and at 30,60,120min after oleic acid or normal saline administration. Two hours later, the animals were killed, the malondialdehyde (MDA) the superoxide dismutase (SOD) content in lung, content of lung water, lung/body ratio were measured, and pathologic changes of lung tissue were observed microscopically.
    2. Forty patients receiving ordinary thoracic operation were randomly divided into 2 groups: control group received normal balance salt solution and therapeutic group received hyperoxia balance salt solution. Solution in both groups was transfused 10 min after tracheal tube extraction. The blood gases in all patients were analyzed at 0 min, 120 min in transfusion and 120 min after transfusion. The vital signs were recorded and side reactions were observed at the same time.
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