体外循环行肺动脉灌注液对术后肺功能的保护

目的探讨体外循环(CPB)期间行肺动脉灌注液对术后肺功能的保护作用。方法 2007年1月-2011年4月30例在CPB下行单纯二尖瓣人工机械瓣置换术患者,随机分成肺保护组和对照组各15例,肺保护组患者CPB期间经肺动脉灌注低温肺保护液,对照组患者CPB期间未经肺动脉灌注低温肺保护液。监测两组患者在麻醉诱导后、阻断主动脉l0 min及开放主动脉l0 min,2、12、24 h各时间点的呼吸指数(RI)、氧合指数(OI)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)及术前、术后肺动脉压力(PAPm)、静态肺顺应性(CLS)、气道阻力(AR)变化,并比较术后ICU监护时间、术后呼吸机辅助时间、住院天数及有无术后并发症等。结果两组IL-6、TNF-α、RI、OI、PAPm、AR、CLS比较差异均有统计学意义(P<0.05)。但术后ICU监护时间及住院时间比较差异均无统计学意义(P>0.05)。结论 CPB期间行肺动脉灌注对术后肺功能具有保护作用。

Protection of Postoperative Lung Function by Cardiopulmonary Bypass Pulmonary Artery Perfusion Fluid

Objective To study the protective effect of cardiopulmonary bypass(CPB) pulmonary perfusion on postoperative lung function.Methods Thirty patients receiving purely artificial mitral valve replacement surgery with CPB between January 2007 and April 2011 were randomly divided into the lung protection group and the control group with 15 patients in each.For patients in the lung protection group,pulmonary artery perfusion with hypothermic protective solution during the CPB period was performed,while patients in the control group received no protective solution.Then,we monitored respiratory index(RI),oxygenation index(OI),IL-6,and TNF-α after induction of anesthesia,10 minutes after aortic cross-clamping,and l0 minutes,2 hours,12 hours,and 24 hours after aortic opening,and preoperative and postoperative pulmonary artery pressure(PAPm),static lung compliance(CLS),and airway resistance(AR).Furthermore,we compared the ICU caring time,postoperative ventilation time,hospital stay and the presence of postoperative complications between the two groups.Results IL-6,TNF-α,RI,OI,PAPm,AR,and CLS between the two group of patients had significant differences(P<0.05).However,postoperative ICU care time and hospital stay were not statistically different(P> 0.05).Conclusion Pulmonary arterial perfusion during CPB has a protective effect on postoperative pulmonary function.