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目的探讨间歇正压通气（ＩＰＰＶ）对胸部火器伤致肺损伤犬的早期救治作用。方法杂种犬１４只，随机分为对照组（６只）和ＩＰＰＶ组（８只）。麻醉后得用０．４ｇ钢珠射击犬右侧胸部。对照组仅行伤口封闭，输液及胸腔闭式引流。ＩＰＰＶ组除进行上述操作外，于致伤后２０分钟行ＩＰＰＶ。测量血流动力学指标，并做血气分析。结果致伤即刻，对照组犬平均动脉血压（ＭＡＰ）和峰值气道压（ＰＩＰ）较致伤前显著升高（Ｐ＜０．０５），致伤后２０分钟，ＰａＯ２、ｐＨ、氧饱合度（ＳａＯ２）、平均动脉压（ＭＡＰ）及心率（ＨＲ）均显著降低（Ｐ＜０．０１），ＰａＣＯ２及ＰＩＰ显著升高（Ｐ＜０．０１），致伤后４０，６０分钟，上述变化呈渐进性加剧，动物平均存活时间为（３８±２５）分钟。ＩＰＰＶ组犬在致伤即刻及２０分钟，上述指标变化与对照组相似；应用ＩＰＰＶ后，ＰａＯ２，ＳａＯ２，ＭＡＰ，ＨＲ及ＰＩＰ较对照组增显著升高（Ｐ＜０．０１），ＰａＣＯ２显著降低（Ｐ＜０．０１），动物平均存活时间为（４６９±３２８）分钟。结论严重胸部火器伤致肺损伤犬早期即可出现明显的呼吸功能不全。应用ＩＰＰＶ可改善胸部火器伤致肺损伤犬的气体交换，显著延长存活时间。
Objective To investigate the effect of intermittent positive pressure ventilation (IPPV) on the early treatment of dogs with lung injury induced by chest firearm injury. Methods 14 mongrel dogs were randomly divided into control group (6 mice) and IPPV group (8 mice). After anesthesia use 0.4g steel ball to hit the dog’s right chest. The control group only wound closure, infusion and closed thoracic drainage. IPPV group in addition to the above operation, 20 minutes after injury line IPPV. Measurement of hemodynamic indicators, and blood gas analysis. Results The average arterial blood pressure (MAP) and peak airway pressure (PIP) of dogs in control group were significantly higher than those before injury (P <0.05). PaO2, pH, oxygen saturation (P <0.01), PaCO2 and PIP increased significantly (P <0.01), and the changes of SaO2, MAP and HR (P <0.01) Increased progressively, the average survival time of animals (38 ± 25) minutes. Compared with the control group, the changes of these indexes in IPPV group were similar to those in the control group. PaO2, SaO2, MAP, HR and PIP increased significantly (P <0.01) and PaCO2 decreased significantly (P <0.01). The average survival time of animals was (469 ± 328) minutes. Conclusion Severe thoracic firearm injury may lead to obvious respiratory insufficiency in early stage of lung injury. Application of IPPV can improve gas exchange in canine lung injury caused by chest firearm injury and significantly prolong the survival time.