婴儿心肺循环时持续性肺动脉灌注对肺的保护作用

目的　探讨婴儿心肺循环时持续性肺动脉灌注对肺的保护作用。方法　 3 0个室间隔(房间隔 )缺损合并肺动脉高压的婴儿随机分为试验组和对照组各 15例 ,试验组进行持续性的肺动脉灌注 ,对照组不进行肺动脉灌注。PaO2 /FiO2 (动脉氧分压 /吸入氧浓度 )及中性粒细胞计数作为评价指标。结果　PaO2 /FiO2 水平试验组在 3h、6h和 12h明显高于对照组 (P <0 .0 5,P <0 .0 1,P <0 .0 0 1) ,在主动脉开放后 3 0min ,两组的中性粒细胞计数低于体外循环前 ,在试验组无统计学意义 (P >0 .0 5) ,在对照组有统计学意义 (P <0 .0 0 1)。结论　停止的肺循环在心肺循环过程中是引起肺损伤的主要危险因素 ,持续性肺动脉灌注对防止肺损伤是有效的

protective effect of continuous pulmonary perfusion during cardiopulmonary bypass on lung injury in infants

Objective To investigate the protective effects of co nt inuous pulmonary perfusion during cardiopulmonary bypass (CPB) on lung injury in infants.Methods Thirty infants with ventricular septal defect (VSD)or atrioventricular septal defect(ASD)complicated with pulmonary hypert ension were enrolled and randomly assigned to two groups,every group,15 patients, was performed with CPB during the operation.The ratio o f partial pressure of to oxygen in artery to fractional concentration of oxygen in inspired gas (PaO 2/FiO 2)and neutrophil counts were assessed from pre-sur gery to 24 h later termination of CPB. Results PaO 2/FiO 2 wa s higher in the experiamental group at 3 h,6 h and 12 h than that in the control group(P<0.05, P<0.01 and P<0.001)respectively.Neutrophil counts decreased below prebypass values in both groups at 30 min after aortic unclampi ng, and the difference was significant in the control group but was not in the g roup. Conclusion The arrested pulmonary circulation during CPB is the major risk factor of lung injury and CPB is effective in preventing lung injury.