改良超滤对成人瓣膜置换术早期预后的影响

目的 :了解改良超滤对成人瓣膜置换术早期预后的影响。方法 :10 3例成人瓣膜替换术患者 ,随机分为常规超滤组 (CUF组 ,n =5 5 )和改良超滤组 (MUF组 ,n =4 8)。分别于术中应用常规和改良超滤技术 ,对 2组术后早期的临床资料进行比较分析。结果 :全部病例中心功能Ⅳ级的患者相比 ,MUF组术后即刻心指数 (CI) ,左室每搏功指数 (LVSWI)和每搏指数 (SVI)均明显高于CUF组术后即刻CI(P <0 0 1) ,LVSWI和SVI(P <0 0 5 ) ,其中CI在术后 6h仍显著高于CUF组 (P <0 0 5 ) ,2组间SVR ,PVR ,RVSWI无明显差异。MUF组术后红细胞压积 (HCT)和氧合指数 (OI)均显著高于CUF组 (P <0 0 1) ,术后2 4h尿量明显少于CUF组 (P <0 0 1)。与CUF组相比 ,MUF组的呼吸机辅助通气时间和ICU监护时间均明显缩短 (P <0 0 5 )。结论 :与常规超滤法相比 ,改良超滤可以在术后迅速浓缩血液 ,减轻机体水肿 ,保护心肺功能 ,有利于改善术后早期的预后

The effect of modified ultrafiltration on the prognosis during the early postoperative period in adult valve replacement patients

Objective:To examine the impact of modified ultrafiltration on the prognosis during the early postoperative period in adult valve replacement patients.Method:103 adult patients were randomly divided into two groups:conventional ultrafiltration group(CUF, n =55) and modified ultrafiltration group(MUF, n =48).After the application of conventional and modified ultrafiltration respectively,we compared the relevant clinical information between the two groups.Result:The patients with cardiac function Ⅳ in MUF group had a higher CI( P <0 01),LVSWI and SVI( P <0 05) than those in CUF group at the end of operation,and they still had higher CI( P <0 05) at 6 hour after surgery.The hematocrit and respiratory index in MUF group were significantly higher than that in CUF group( P <0 01);the amounts of urine during the first 24 h after operation in MUF group were lesser( P <0 01).The time of mechanical ventilation and ICU staying were significantly shorter in MUF group than that in CUF group ( P <0 05).Conclusion:Compared with conventional ultrafiltration,the modified ultrafiltration is useful to hemoconcentrate,reduce postoperative body weight gain,protect cardiac and pulmonary function,and improve the early prognosis during the early postoperative period in adult valve replacement patients.