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吸入性损伤后单叶肺肺水肿

[Pulmonary edema in an isolated lobe after inhalation injury].

作者信息

Guo Z R

机构信息

PLA 304th Hospital, Beijing.

出版信息

Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1990 Jun;6(2):121-4, 159.

PMID:2397433
Abstract

In order to know the regularity of forming edema after thermal injury, we performed experiments of pulmonary edema in isolated lobes with steam and obtained direct continuous measurements of transudation as it occurs. Transvascular flux (Qf) and gain weight (Gw) of the lobe increased immediately and the peak value of exudation occurred within half an hour after inhalation injury. Studies in protein content, colloid osmotic pressure of bronchus exudate and water content of lung, reconfirmed increase in pulmonary capillary permeability. Marked hemoconcentration was revealed. Plasma leaked 145 ml (32.5%), plasma protein leaked 2.9 g (15%) during the experiment. According to pressure of artery (Pa), vein (Pv), arterial occlusion (Pao), venous occlusion (Pvo), double occlusion (Pdo) and blood flow through the lobe (QT), the total vascular (Rt) arterial (Ra), middle compartment (Rmid), and venous (Rv) resistances were calculated. All the resistances indicated an increase and QT showed a decrease after inhalation injury. The experimental results suggested that tissue ischemia is significant after thermal injury and resuscitation should be started as early as possible and should include whole blood or plasma in resuscitation regimes during burn shock phase.

摘要

为了解热损伤后水肿形成的规律,我们用蒸汽对离体肺叶进行肺水肿实验,并对渗出过程进行了直接连续测量。吸入损伤后,肺叶的跨血管通量(Qf)和增重(Gw)立即增加,渗出峰值出现在吸入损伤后半小时内。对支气管渗出液的蛋白质含量、胶体渗透压及肺含水量的研究再次证实了肺毛细血管通透性增加。出现明显的血液浓缩。实验期间,血浆漏出145毫升(32.5%),血浆蛋白漏出2.9克(15%)。根据动脉压(Pa)、静脉压(Pv)、动脉阻断压(Pao)、静脉阻断压(Pvo)、双重阻断压(Pdo)及流经肺叶的血流量(QT),计算了总血管阻力(Rt)、动脉阻力(Ra)、中间腔室阻力(Rmid)和静脉阻力(Rv)。吸入损伤后,所有阻力均升高,QT降低。实验结果表明,热损伤后组织缺血明显,应尽早开始复苏,在烧伤休克期的复苏方案中应包括全血或血浆。

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