论文部分内容阅读
背景:如何在热缺血期给予无心跳供体肺提供保护进而降低移植后原发性移植物失功能是所有研究者和临床医生面前的首要问题。目的:从病理学角度评价部分液体通气在无心跳供体肺移植中对供体肺的保护作用。方法:将36只清洁级SD大鼠随机均分为3组,应用自制16G深静脉留置针作气管插管,行气管切开并连接至呼吸机行机械通气。经颈静脉注入KACL溶液猝死大鼠,用多导生理检测仪连续记录血压,在血压变为0mmHg时,认为造模成功,模型建立后氧气组大鼠继续给予机械通气2h;盐水组和氟化碳组先给予盐水和氟化碳5min的纯氧通气,后从气管插管中注入相当于功能残气量的高氧盐水和高氧氟化碳(10mL/kg),并给予机械通气2h。结果与结论:大体观察盐水组肺脏肿胀,肺组织表面片状出血,肺呈暗红色,气道内有血性水肿液;氧气组见肺脏肿胀较轻,肺表面有少量出血点;氟化碳组肺组织炎症细胞浸润和组织水肿明显减轻。光镜下盐水组和氧气组呈弥漫性肺泡和间质充血、水肿,支气管壁及毛细血管周围有大量的炎性细胞浸润和肺泡过度膨胀,肺泡壁断裂;氟化碳组肺组织细胞结构较为完整,无明显破坏。结果可见部分液体通气可以对无心跳供肺起到很好的保护作用。
Background: How to protect unsintered donor lungs during warm ischemia and thus the loss of primary graft loss after transplantation is the primary issue facing all researchers and clinicians. OBJECTIVE: To evaluate the protective effect of some liquid ventilation on donor lung in non-heartbeat donor lung transplantation from the pathological point of view. Methods: Thirty-six clean-grade SD rats were randomly divided into three groups. A 16-gauge deep venous catheter was used for tracheal intubation. The tracheotomy was performed and connected to ventilator for mechanical ventilation. Rats were injected with KACL through the jugular vein, and the blood pressure was recorded continuously by a multi-channel physiological detector. When the blood pressure became 0mmHg, the model was considered successful. After the model was established, the rats in the oxygen group were continued to receive mechanical ventilation for 2h. The carbon group was given pure oxygen ventilation of saline and carbon fluoride for 5 min. Then, hypercapnic saline and hyperfluorocarbon fluoride (10 mL / kg) equivalent to functional residual volume were injected from the endotracheal tube and ventilated for 2 h. RESULTS AND CONCLUSION: The general observation was that in the saline group, the lungs were swollen, the flakes of the lung surface were flaccid, the lungs were dark red and the bloody edema was found in the airway. In the oxygen group, the swollen lungs were lighter and there were a few bleeding spots on the surface of the lungs. Tissue inflammatory cell infiltration and tissue edema significantly reduced. Under the light microscope, diffuse alveolar and interstitial hyperemia, edema were observed in the saline group and the oxygen group, with a large number of infiltration of inflammatory cells and excessive alveolar infiltration of the bronchial wall and capillaries, and rupture of the alveolar wall. The cellular structure of the lung tissue in the fluorocarbon group was Complete, no obvious damage. The results show that part of the liquid ventilation can be no heart to heart for the lungs to play a very good protective effect.