不同超滤膜对体外循环术后呼吸功能的影响

目的 探讨在体外循环术中使用两种不同的膜材料进行超滤对术后呼吸功能的保护效果。方法 将30例体外循环心内直视手术患者随机均分成吸附组和对照组,吸附组使用AN69膜,对照组使用PS膜进行术中超滤。各组分别于体外循环前、体外循环结束后5、60、120、180、240min,测定气道平台压(P_(Plateau))、气道峰压(P_(Peak))、静态胸肺顺应性(Cst)、动态胸肺顺应性(Cdyn)和呼吸指数(RI)的变化。结果 在体外循环结束后5～240min期间,吸附组P_(Plateau)、P_(Peak)和RI升高、Cst和Cdyn降低的程度显著低于对照组(P<0.05),持续时间短于对照组(P<0.05)。两组均无死亡,无血红蛋白尿。结论AN69膜较PS膜超滤可更明显地减轻体外循环引起的肺损伤,改善呼吸功能。

Ultrafiltration with different membranes and respiratory function after cardiopulmonary bypass

Objective To investigate the protective effect of ultrafiltration on pulmonary function after cardiopulmonary bypass (CPB) by comparing two different membranes used in the ultrafiltration. Methods Thirty patients undergoing cardiac surgery with CPB were randomly divided into adsorption group (n=15) and control group (n=15), and in the former group, AN69 membrane was used for ultrainfiltration, with polysulfone (PS) membrane adopted in the control group during CPB. Plateau airway pressure (P_(Platesu), peak airway pressure (P_(Peak)), static pulmonary compliance (Cst), dynamic pulmonary compliance (Cdyn) and respiratory index (RI) were measured or calculated before and 5, 60, 120, and 240 min after CPB in each group respectively. Results During the period of 5 to 240 min after CPB, the increase in P_(Plateau), P_(Peak), RI and decrease in Cst and Cdyn were much more obvious and lasted for longer time in the adsorption group than in the control group (P<0.05). No operative death or hemoglobinuria occurred in these cases. Conclusion Ultrafiltration with AN69 membrane more effectively reduces CPB-induced lung injury and improves the postoperative respiratory function than with PS membrane.