肺动脉灌注参芪扶正注射液对体外循环肺损伤影响作用的观察

目的探讨体外循环心脏直视手术中肺动脉灌注参芪扶正注射液（简称参芪液）对肺损伤的影响。方法选择心脏瓣膜病变伴肺动脉高压的患者22例，分为参芪液组和对照组，每组11例。两组均在升主动脉阻断心脏静止后，经主肺动脉灌注肺保护液。对照组灌注纯氧合血肺保护液，参芪液组灌注由参芪液与氧合血组成的肺保护液；分别于转流前、转流结束时、转流结束后6h、24h测定并记录两组肺循环血浆丙二醛（MDA）含量、肺血管阻力（PVR）、静脉血与动脉血白细胞比值及呼吸机辅助通气时间。结果两组MDA和PVR较转流前均升高（P〈0．05），但参芪液组升高程度明显低于对照组（P〈0．05），并且在术后24h基本恢复至术前水平；两组静脉血白细胞／动脉血白细胞比值在转流结束时及转流结束后6h均高于转流前，但参芪液组明显低于对照组（P〈0．05）；参芪液组呼吸机辅助通气时间为（16．1±5．5）h，明显少于对照组的（29．1±6．9）h（P〈0．01）。结论参芪液能减轻体外循环心脏直视手术后的肺损伤。

Effects of Pulmonary Arterial Perfusion with Shenqi Fuzheng Injection on Lung Injury During Cardiopulmonary Bypass

OBJECTIVE: To observe the effect of pulmonary arterial perfusion with Shenqi Fuzheng Injection (SFI)on lung injury during cardiopulmonary bypass (CPB). METHODS: Twenty-two patients with cardiac valvular disease and pulmonary hypertension were randomly divided into the control and the SFI group equally. SFI mixed pure oxygenated blood to the SFI group, and oxygenated blood alone to the control group was perfused via pulmonary artery during CPB. Plasma malondialdehyde (MDA), pulmonary vascular resistance (PVR), ratio of leucocyte counts in venous and arterial blood, and time of mechanical ventilation applied were measured before and at the end of CPB, and 6th, 24th hours after CPB. RESULTS: After treatment, MDA content and PVR were significantly higher than those before CPB (P < 0.05), and reduced to normal level 24 h after CPB in both groups, but the peak levels were lower in the SFI group than those in the control group (P < 0.05). The leucocyte counts ratio in venous and arterial blood were significantly higher at the end of CPB and 6 h later than those before CPB in both groups (P < 0.05), but the increment were lower in the SFI group than those in the control group (P < 0.05). Furthermore, the applying mechanical ventilation time in the SFI group was 16.1 +/- 5.5 h, significantly shorter than that in the control group (29.1 +/- 6.9 h, P < 0.01). CONCLUSION: Pulmonary arterial perfusion with SFI could alleviate the CPB induced lung injury.