改良超滤法对体外循环后肺顺应性和呼吸指数的影响

目的：评价改良超滤技术在成人体外循环手术中对患者术后肺顺应性和呼吸指数的临床效果。方法将风湿性瓣膜病拟行单纯人工瓣膜置换术患者60例,随机分成两组：改良超滤组（Ⅰ组）和非超滤组（Ⅱ组）。两组患者的年龄、体重、心功能分级、主动脉阻断时间、体外循环时间、手术时间等无明显差异。观察两组患者CPB前，CPB停止后即刻，术后2h、6h、12h肺静态顺应性及呼吸指数，分析改良超滤技术应用成人体外循环术后的影响。结果两组患者肺顺应性（Cstat）、呼吸指数（RI）在CPB前并无统计学差异（P〉0.05）；与CPB前相比，两组患者CPB停止后即刻Cstat有明显下降（P〈0.05），手术后逐渐回升；与Ⅱ组相比，Ⅰ组CPB停止后即刻、术后2h、6h、12h Cstat均有明显上升，有统计学差异（P〈0.05）。与CPB前相比，两组患者CPB停止后即刻RI有明显上升（P〈0.05），手术后逐渐下降；与II组相比，Ⅰ组CPB停止后即刻、术后2h、6h、12h均有明显下降（P〈0.05）。结论改良超滤技术应用成人体外循环可以明显提高术后肺的顺应性及降低呼吸指数。

Effect of modified ultrafiltration on Cstat and respiratory index in Cardiopulmonary bypass

Objective To evaluation the effect of modified ultrafiltration technique in adult cardiopulmonary bypass surgery on postoperative pulmonary compliance and respiratory index. Methods sixty patients were randomized into two groups：the modified ultrafiltration group （groupⅠ,n=30） and non-UF group （group Ⅱ,n=30）. There were not significant differential between the groupⅠand group II before CPB,at the end of CPB,after 2h,6h and 12h,analysis of the effect of modified ultrafiltration after car-diopulmonary bypass in adults. Results There were not significant differential between two groups of patients on Cstat and RI be-fore CPB （P〉0.05）;compared with before CPB,Cstat decreased significantly at the end of CPB （P〈0.05）,gradual recovery after surgery,and compared to the group Ⅱ,the groupⅠwere significantly increased after CPB and postoperative after 2h,6h and 12h （P〈0.05）. Compared with the before CPB,the two groups of patients had significantly increased RI after CPB and surgery （P〈0.05）, compared with group Ⅱ,groupⅠstopped immediately after CPB,postoperative after 2h 6h and 12h were significantly decreased （P〈0.05）. Conclusion During adult CPB,modified ultrafiltration technology can significantly improve postoperative lung compli-ance and reduce respiratory index.