改良超滤对成人心脏瓣膜替换术后左心功能的影响

目的：探讨改良超滤对成人心脏瓣膜替换术后左心功能的影响。方法：22例成人心脏瓣膜替换术患者随机分为改良超滤（MUF）组（n=10)和无超滤对照组（n=12)，动态观察体外循环（CPB）前、CPB停时及MUF结束时（对照组CPB停后15min)3个时间点心排量（CO）、心排指数（CI）、每搏输出量（SV）、每搏指数（SVI）、平均动脉压（MAP）、左室每搏做功指数（IVSWI）等心功能指标。结果：MUF组超滤后CO、CI、SV、SVI、LVSWI均较CPB停时明显升高（P＜0.05)；对照组停CPB时与CPB停后15min相比，各项指标无显著性差异。MUF组超滤后与对照组CPB停后15min相比，CI和LVSWI升高显著（P＜0.05)。结论：在成人心脏瓣膜替换术中，应用改良超滤技术可以减轻心肌水肿，提高心脏指数，改善术后早期心功能。

Modified ultrafiltration improves left ventricular function after replacement of adults' heart valves

Objective:To test the hypothesis that use of modified ultrafiltration (MUF) after cardiopulmonary bypass can improve blood dynamics in adults' valve replacement.Methods:Twenty two adult patients undergoing valves replacement were randomized into MUF group( n =10) and control group( n =12).Their CO,CI,SV,SVI,LVSWI,and MAP at pre CPB,end CPB,and post MUF (or 15 min post CPB in control group) were measured.Results:In the MUF group,CO,CI,SV,SVI,MAP,LVSWI at post MUF increased significantly compared with those end CPB( P <0.05); In MUF group CI and LVSWI were significantly higher at post MUF point than those in control group at 15 min post CPB ( P <0.05).Conclusion:MUF in adults' valve replacement can improve left ventricular systolic function and diastolic compliances,improve cardiac index and cardiac function.