西京-87型鼓泡式氧合器应用于70公斤以上患者临床评价

在心脏外科飞速发展的今天,人工心肺机的好坏直接影响心内直视手术的顺利进行及术后各种并发症的发生,我院1989年12月至1998年5月共施行体外循环手术3572例,其中70公斤以上者106例,有54例应用了西京-87型鼓泡式氧合器收到了良好的效果.54例患者,男48例,女6例,年龄平均41(19～59)岁;体重70～88kg,平均75.6kg;体表面积平均1.82m~2;冠状动脉阻闭时间10～142分钟,平均52分钟;灌注时间22～434分钟,平均104分钟;氧血比值为0.3～0.6:1;静脉血氧饱和度维持在65%～80%.用西京-87型鼓泡式氧合器,优选了适宜孔径的氧弥散器,从而解决了大体重病人氧合差的问题.体重最高者达88kg,氧血比例0.6:1～0.5:1,静脉血氧饱和度能维持在65%～80%.体现了该氧合器氧合性能好,而且携氧量高,既使应用于长时间或高流量灌注也能维持较稳定的氧合状态.而且热交换系统达到了降复温标准系数,在高体重患者降复温过程效果满意.本氧合器祛泡性能良好,对防止气栓的发生起到了保障.全组未见动脉气栓及脑缺氧症者.该氧合器氧血比值小,氧合性能好,而且集氧合、热交换、祛泡、过滤和贮血于一体,从而对血液有形成都份破坏程度减轻.对减少心、脑、肺、肾的并发症起到了良好的作用.西京-87型鼓泡式氧合器适用于不同体重患者的心内直视手术体外循环灌

Clinical Evaluation on XUING-87 Bubble Oxygenator in Patients with Body Weight above 70 Kilogram

In rapid progress of cardiovascular surgery, the quality of oxygenator has great importance on affecting the management of open heart operation and the occurence of various complications. In this hospital from December 1989 to July 1998 there were 3 572 cases operation with cardiopulmonary bypass. Among these patients, 106 cases were more than 70kg of body weight, and 54 of them managed with XIJING-87 oxygenators and achieved good results.In the 54 cases, there were 48 male, 6 female, average aged 41, body weight 70-88kg (average 75kg), average body surface area 1. 83m2, the aortic crossclamping time 10-142min (average time 52min), perfusion time was 22-434min (average time 104min), ratio of oxygen to blood 0.3-0.6 : 1, saturation of venous blood 65 % ~ 80 % .In XIJING-87 oxygenantor, the oxygen spreader was optimized with appropriate openning diameter to solve the problem of inadequate oxygenation in patients with heavy body weight. In the 54 patients the heaviest body weight was 88kg, in this case the ratio of oxygen to blood was 0.6 : 1 - 0.5 : 1 and the oxygensaturation of venous blood was maintained at the level of 65 % -80 % . All of the above points indicated of oxygen earring, which could maintain stable oxygenation in long time performance and high-flow rate perfusion.The heat exchange system of this oxygenator had reached standard index, and reached statis-factory results in cooling and rewarming process in the patient with heavy body weight. This oxygenator has good quality of bubble removing to prevent air embolism. There was no occurance of arterial air embolism, and cerebral anoxia in these patients. This oxygenator had low oxygen-blood ratio, good quality of oxygenation, and was the unification of oxygenation heat exchange, bubble removing, blood filter and storage, which had less destroying effect on blood components and prevented the complications in brain, lung and kidney. XIJING oxygenator is appropriate for patients of various body weight in cardiopulmonary bypass surgery. It is disposable and safe to manipulate.