深低温体外循环方法对婴儿肺功能的影响

目的 研究深低温停循环(DHCA)和深低温低流量(DHLF)两种转流方法对先心病婴儿肺功能的影响程度。方法 20例室间隔缺损伴肺动脉高压患儿,随机分为DHCA组和DHLF组。分别于转流前(TO),转流结束后5min(TI),转流结束后2h(T2),测定肺静态顺应性(Cstat)、肺气道阻力(Raw)、呼吸指数(RI)值。结果 1.DHLF组术后ICU滞留时间明显高于DHCA组(P<0.05)。2.转流结束后(T1,T2)DHCA组和DHLF组的Cstat都较体外循环开始前(TO)明显降低(P<0.01),Raw、RI都明显升高(P<0.01);T2时在Cstat方面,DHLF组的下降程度明显大于DHCA组(P<0.01),RI方面增加的程度明显大于DHCA组(P<0.01)。结论 DHLF和DHCA两种转流方法都能明显引起先心病婴儿肺功能受损,但DHLF较DHCA对肺的损伤更为严重。

Changes on lung function after deep hypothermic cardiopulmonary bypass in infants

Objective To examines the effect of deep hypothermic low-flow (DHLF) vs. deep hypothermia and circulatory arrest (DHCA) on lung function in infants. Methods Twenty infants with VSD/PH were randomly de-vided into two average groups: DHLF and DHCA. Measurements of static pulmonary compliance, airway resistance and respiratory index were performed before institution of cardiopulmonary bypass (CPB) (T0) , 5 min (T1) and 2 h (T2) after cessation of CPB. Results Both DHLF and DHCA could cause impairment of static pulmonary compliance , airway resistance and respiratory index after CPB (P< 0. 01) . There was greater impairment of pulmonary compliance and respiratory index after DHLF than after DHCA (P< 0.01). The ICU stay time of DHLF group was significantly longer than that of DHCA group (P< 0.05 ) . Conclusion Both DHLF and DHCA could cause pulmonary injury in infants, but DHLF did more harm to the lung than DHCA.