体外循环中肺动脉灌注和间断肺通气的肺保护作用
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江苏省卫生厅医学科技发展基金(H200603)


Protective effects of pulmonary artery perfusion and intermittent ventilation on lung during cardiopulmonary bypass
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    摘要:

    目的: 探讨肺动脉灌注4℃含氧冷血和间断肺通气对体外循环(cardiopulmonary bypass,CPB)肺损伤的保护作用-方法: 将30例符合条件的心脏手术患者采用随机数字表法分为两组:肺保护组(n=15):CPB期间经肺动脉间断灌注4℃含氧冷血,并在灌注期间给予间断肺通气;对照组(n=15):常规行心脏手术-记录呼吸机支持时间;分别在CPB前和CPB结束及结束后1-6 h测算氧合指数(OI)-呼吸指数(RI)-肺气道阻力(Raw)和肺静态顺应性(Cstat)-结果: 术后肺保护组呼吸机支持时间明显短于对照组(P < 0.05),肺保护组CPB结束后1-6 h OI-Cstat均显著高于对照组(P < 0.05或P <0.01),而RI-Raw均显著低于对照组(P <0.05和P < 0.01)-结论: 肺动脉含氧冷血间断灌注及间断肺通气对CPB肺损伤有良好的保护作用-

    Abstract:

    Objective:To explore the protective effects of comprehensive measures,including pulmonary artery perfusion with 4℃ oxygenated blood and intermittent ventilation on lung during CPB. Methods:Thirty patients with rheumatic heart disease(RHD) or congenital heart defect(CHD) were divided into two groups with random number table: protective group (n =15), given simultaneously intermittent ventilation and pulmonary artery perfusion with 4℃ oxygenated blood on lung during CPB; control group (n =15) , performed using routine approaches. Mechanical ventilation time was recorded, the lung oxygenate index(OI), respiratory index (RI), airway resistance(Raw) and lung static compliance (Cstat) were detected at the beginning, ending,1 h and 6 h after CPB termination, respectively. Results:The time of mechanical ventilation was significantly shorter in protective group than in the control group. The OI and Cstat of protective group at 1 h and 6 h after CPB termination was significantly better than that of the control group (P < 0.05, P < 0.01, respectively); the Raw and RI of protective group was significantly lower than that of control group at 1 h and 6 h (P < 0.05, P < 0.01, respectively). Conclusion:Comprehensive measures, pulmonary artery perfusion with 4℃ oxygenated blood and intermittent ventilation, has protective effects on lung injury during CPB.

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任王胜,吴延虎,王晓伟,刘 翔,梁永年,朱锦富.体外循环中肺动脉灌注和间断肺通气的肺保护作用[J].南京医科大学学报(自然科学版),2011,(6):843-846

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  • 收稿日期:2010-12-30
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