目的 探讨星状神经节阻滞（stellate ganglion block, SGB）对兔呼吸机相关性肺损伤（ventilator associated lung injury, VALI）的影响。 方法 40只成年日本大耳兔按随机数字表法分为两组（每组20只）：空白对照组（Ⅰ组）和SGB组（Ⅱ组）。Ⅰ组全身麻醉气管插管后椎旁注入生理盐水（0.5 ml），Ⅱ组全身麻醉气管插管后给予SGB。分别于机械通气后1 h（T1）、2 h（T2）、4 h（T3）、6 h（T4） 4个时间点经耳缘静脉抽取静脉血3 ml后处死白兔，检测血清丙二醛（malondialdehyde, MDA）、TNF-α浓度及超氧化物歧化酶（superoxide dismutase, SOD）活性；取左肺组织测量湿/干重比（wet/dry, W/D）；取一部分右肺组织H-E染色后光镜和电镜观察其病理变化，另一部分匀浆后检测MDA含量、髓过氧化物酶（myeloperoxidase, MPO）及SOD活性。 结果 与Ⅰ组比较，Ⅱ组肺组织的W/D［（6.07±0.12）比（8.58±0.48）］和SOD活性［（64±10） U/mg比（77±11） U/mg］明显降低（P<0.01）；Ⅱ组肺组织的MDA含量［（0.89±0.12） μmol/g比（0.63±0.11） μmol/g］和MPO活性［（0.46±0.09） U/g比（0.28±0.07） U/g］明显升高（P<0.01）。H-E染色后光镜和电镜观察Ⅱ组肺组织病变轻于Ⅰ组。与Ⅰ组比较，Ⅱ组血清MDA、TNF?蛳α在 T2~T4时间点降低（P<0.05），Ⅱ组血清SOD在T2~T4时间点升高（P<0.05）。 结论 SGB可以减轻机械通气兔肺组织的损伤，产生肺保护作用。
Ｏｂｊｅｃｔｉｖｅ To evaluate the effects of stellate ganglion block(SGB) on rabbit ventilator associated lung injury(VALI). Methods Forty rabbits were randomly divided into two groups(n=20): the control group (groupⅠ) and the SGB group(groupⅡ). GroupⅠ is only given NS. GroupⅡis stellate ganglion block. Wet/dry(W/D), activities of superoxide dismutase(SOD), myleoperoxidase(MPO), and level of malondialdehyde(MDA) in lung tissue were detected at the time of 1 h(T1), 2 h(T2), 4 h(T3), 6 h(T4) after mechanical ventilation. MDA, TNF-α and SOD in serum were measured. Results W/D and activities of SOD in groupⅡ were both significantly lower than groupⅠ[(6.07±0.12) vs (8.58±0.48), (64±10) U/mg vs (77±11) U/mg](P<0.01), level of MDA and activities of MPO were significantly higher than groupⅠ[(0.89±0.12) μmol/g vs (0.63±0.11) μmol/g, (0.46±0.09) U/g vs (0.28±0.07) U/g](P<0.01). The lung tissue lesion showed from HE staining under light microscope and electron microscope in groupⅡ was lighter than group I. Compared with groupⅠ, serum MDA and TNF-α of the rabbits in groupⅡat T2-T4 time points were significantly lower (P<0.05). Compared with groupⅠ, serum SOD in groupⅡ at T2-T4 time points significantly rised(P<0.05). Conclusions SGB reduced the injury of lung tissue in rabbits with mechanical ventilation and had a protective effect to lung.
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