| 郝文瀚,那巍兰,李邑刍,曲东,袁新宇,闫淯淳.CT定量分析急性呼吸窘迫综合征模型兔肺复张呼气末正压通气最佳压力[J].中国医学影像技术,2022,38(3):321~325 |
| CT定量分析急性呼吸窘迫综合征模型兔肺复张呼气末正压通气最佳压力 |
| CT quantitative analysis on optimal pressure of positive end expiratory pressure ventilation for lung recruitment for rabbit models of acute respiratory distress syndrome |
| 投稿时间：2021-08-05 修订日期：2022-01-12 |
| DOI：10.13929/j.issn.1003-3289.2022.03.001 |
| 中文关键词: 兔 呼吸窘迫综合征 正压呼吸 肺复张 体层摄影术,X线计算机 |
| 英文关键词:rabbits respiratory distress syndrome positive-pressure respiration lung recruitment tomography, X-ray computed |
| 基金项目:北京市科技计划首都特色临床应用研究（Z181100001718169）。 |
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| 中文摘要: |
| 目的 以CT定量评估不同肺复张呼气末正压（PEEP）通气治疗急性呼吸窘迫综合征（ARDS）模型兔，并确定最佳PEEP。方法 纳入10只成年大耳兔，建立ARDS兔模型。采用压力控制通气进行肺复张，分别于4、8、12、16、20、24及28 cmH2O PEEP下行肺部CT扫描，并按CT值将肺分为不通气区（－100~100 HU）、低通气区（－500~－101 HU）、正常通气区（－800~－501 HU）及过度通气区（－1 000~－801 HU），并将其占肺组织面积比值记为Rnon、Rlow、Rnormal及Rover；观察肺复张前、后的Rnon、Rlow、Rnormal及Rover变化，分析肺复张最佳PEEP。结果 肺复张过程中，随PEEP升高，Rnon、Rlow、Rnormal及Rover均发生明显变化（P均<0.05）；PEEP为4、8、12 cmH2O时，Rnon两两比较差异均有统计学意义（P均<0.05）；PEEP为4、8、12、16 cmH2O时，Rlow两两比较差异均有统计学意义（P均<0.05）；PEEP为12 cmH2O时的Rnormal明显高于PEEP为4、20、24、28 cmH2O时（P均<0.05）；PEEP为12、16、20、24、28 cmH2O时，Rover两两比较差异均有统计学意义。肺复张最佳PEEP为（12.48±5.72） cmH2O。结论 CT可有效评估肺复张效果；针对ARDS模型兔，推荐PEEP为（12.48±5.72） cmH2O。 |
| 英文摘要: |
| Objective To quantitatively evaluate different lung recruitment positive end expiratory pressure (PEEP) ventilation for rabbit models of acute respiratory distress syndrome (ARDS) with CT, and to explore the optimal value of PEEP. Methods Ten adult big-ear rabbits were enrolled to establish ARDS rabbit models. The recruitment maneuver was performed with pressure controlled ventilation. Lung CT scanning was performed when PEEP=4, 8, 12, 16, 20, 24 and 28 cmH2O, respectively, and the lung filed was divided into 4 ventilation areas according to CT value, i.e. non-ventilated area (-100-100 HU), low-ventilated area (-500--101 HU), normal ventilated area (-800--501 HU) and over inflation area (-1 000--801 HU), and the ratio of different ventilation areas to lung tissue were recorded as Rnon, Rlow, Rnormal and Rover, respectively. The changes of Rnon, Rlow, Rnormal and Rover before and after lung recruitment were observed, and the optimal PEEP was analyzed. Results During lung recruitment, Rnon, Rlow, Rnormal and Rover changed significantly with the increase of PEEP (all P<0.05). When PEEP=4, 8 and 12 cmH2O, there were significant differences of Rnon between each 2 PEEP values (all P<0.05). When PEEP=4, 8, 12 and 16 cmH2O, there were significant differences of Rlow between each 2 PEEP values (all P<0.05). When PEEP=12 cmH2O, Rnormal was significantly higher than when PEEP=4, 20, 24 and 28 cmH2O (all P<0.05). When PEEP=12, 16, 20, 24 and 28 cmH2O, there were significant differences of Rover between each 2 PEEP values (all P<0.05). The optimal PEEP was (12.48±5.72)cmH2O. Conclusion CT could effectively evaluate the effect of lung recruitment PEEP ventilation in ARDS rabbits, and the recommended optimal PEEP was (12.48±5.72)cmH2O. |
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