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目的：通过表面活性物质缺乏的兔肺模型，评估传统通气模式（ｃｏｎｖｅｎｔｉｏｎａｌ ｍｅｃｈａｎｉｃａｌ ｖｅｎｔｉｌａｔｉｏｎ，ＣＭＶ）与允许性高碳酸血症加最佳ＰＥＥＰ（ｐｅｒｍｉｓｓｉｖｅ ｈｙｐｅｒｃａｐｎｉａａｓｓｏｃｉａｔｅｄ ｗｉｔｈｉｄｅａｌＰＥＥＰｖｅｎｔｉｌａｔｉｏｎ，ＰＨＹ＋ ＰＥＥＰｉ）的通气模式对肺损伤的影响，了解肿瘤坏死因子α（ｔｕｍｏｒ ｎｅｃｒｏｓｉｓｆａｃｔｏｒα，ＴＮＦα） 与机械通气引起肺损伤（ｖｅｎｔｉｌａｔｏｒｉｎｄｕｃｅｄｌｕｎｇｉｎｊｕｒｙ，ＶＩＬＩ） 的关系。方法：１２ 只成年兔，以反复肺灌洗法制备表面活性物质缺乏兔肺模型。以ＣＭＶ（Ｃ组） 或ＰＨＹ＋ ＰＥＥＰｉ （Ｐ 组） 通气４ ｈ 后，测定通气前、后的支气管肺泡灌洗液（ｂｒｏｎｃｈｏａｌｖｅｏｌａｒ ｌａｖａｇｅ ｆｌｕｉｄ，ＢＡＬＦ）中ＴＮＦα含量和白细胞分类计数，测定肺水量，进行动脉血气分析和病理检查。结果：ＣＭＶ 组表现为明显的低氧血症，ＢＡＬＦ中较多的中性粒细胞数，总肺水量及血管外肺水量明显增多，肺内病理改变为较明显透明膜形成及炎性细胞聚集；而ＰＨＹ＋ ＰＥＥＰｉ 组引起较少的上述病理、生理变化。且ＣＭＶ 组ＢＡＬ?
OBJECTIVE: To assess the effects of conventional mechanical ventilation (CMV) and permissive hypercapnia associated with peal PEEPi ventilation patterns on lung injury in a surfactant-deficient rabbit lung model To investigate the relationship between tumor necrosis factor α (TNFα) and ventilator-induced lung injury (VILI). Methods: Twelve adult rabbits were subjected to repeated lung lavage to prepare a rabbit lung model with surfactant deficiency. After ventilation for 4 h in CMV group (C group) or PHY + PEEPi group (P group), TNFα level and leukocyte count in bronchoalveolar lavage fluid (BALF) before and after ventilation were measured, lung volume was measured, Blood gas analysis and pathological examination. Results: The CMV group showed obvious hypoxemia. The number of neutrophils, the total amount of pulmonary water and extravascular extracorporeal water in BALF were significantly increased in the CMV group. The pathological changes in the lung tissue were obvious membrane formation and inflammatory cell aggregation ; While PHY + PEEPi group caused less pathological and physiological changes. And CMV group BAL?