不同潮气量机械通气对肺损伤的影响及其针对性护理

摘要

Objective To investigate the effects of different tidal volumes of mechanical ventilation on lung injury and to approach nursing care to aim directly at the factors. Methods Twenty four healthy Sprague Dawley (SD) rats were randomly divided into control group, low tidal volume ventilation group ( VT = 8ml/kg) and high tidal volume group (VT =40ml/kg). Rats were sacrificed and the lung lavage liquid and lung tissue were collected and stored with correct methods. The measured indexes include total protein, WBC, MPO, W/D, TNF-α and TNF-α mRNA expression. Results Compared with control group, total protein, WBC, MPO, W/D, TNF-α and TNF-α mRNA significantly increased in high tidal volume group (P <0. 05). But the indexes above had no statistical differences between low tidal volume group and control group (P >0.05). Conclusions High tidal volume ventilation causes lung injury. Comprehensive prevention and appropriate nursing intervention should be taken.%目的 研究不同潮气量机械通气对肺损伤的影响,探讨机械通气时的针对性护理措施.方法 将24只健康SD大鼠随机分为对照组(n=8)、小潮气量通气组(n=8,VT=8 ml/kg)和大潮气量通气组(n=8,VT=40ml/kg).通气时间均为4 h.检测肺组织总蛋白、肺湿干重比(W/D)、白细胞计数和中性粒细胞髓过氧化物酶(MPO)含量以及肿瘤坏死因子α(TNF-α)蛋白和mRNA的含量.结果与对照组比较,大潮气量通气组肺组织总蛋白、W/D、白细胞计数和MPO含量以及TNF-α蛋白和mRNA含量均显著增加(P<0.05),而小潮气量通气组上述指标的变化无统计学意义(P>0.05).结论 大潮气量机械通气可导致呼吸机所致肺损伤,临床上应加强对机械通气患者的护理防护.