离心泵在高体重患者体外循环中的应用  

The Application of Centrifugal Pump in Patients with High Body Weight during Cardiopulmonary Bypass

作　　者：王军[1] 张宝仁[1] 朱家麟[1] 徐志云[1] 武士英[1] 王连才[1] 邵文玉[1] 

机构地区：[1]第二军医大学长海医院胸心外科,上海200433

出　　处：《生物医学工程与临床》1999年第1期43-45,共3页Biomedical Engineering and Clinical Medicine

摘　　要：1993年5月至1997年6月,我们施行体外循环手术1602例,其中主动脉瓣置换(AVR)为171例,二尖瓣+主动脉瓣置换(DVR)319例,二尖瓣置换(MVR)为458例,先心654例,其中高体重病人为63例(体重大于70kg)(AVR、DVR、MVR、先心分别为19、23、17、4例).采用Lifestrem离心泵结合滚动泵(用于吸引及心肌保护)行体外循环共37例,年龄为31～65岁,体重70～92kg.全组病人麻醉均采用静脉复合麻醉及芬太尼维持麻醉.心肌保护方法均采用中度低温含血心肌保护复合灌注.监测围体外循环期血流动力学变化,测定血中游离血红蛋白含量,观察尿量及尿色.对照组为同期应用滚动泵的大体重病人.结果:应用离心泵的大体重病人术中能够维持平稳的灌注压力,转流平稳,转流中尿量900±200ml,发生肉眼血尿或血色素尿的发生率为17.4%,明显低于未用离心系的病人(89.9%)(P<0.01)血中游离血红蛋白是,应用离心泵的病人为1.9g/L,未用离心泵的病人为7.9g/L两者比较差异非常显著(P<0.01).结论;离心泵在大体重病人体外循环中起到良好的作用.离心泵对血液破坏少,可在术中、术后长时间转流,且安全度高;特别适宜复杂手术及高体重的病人.Sixty-three patients with high body weight (> 70kg) underwent open heart surgery with cardiopulmonary hypass(CPB) from 1993 to 1997. Centrifugal pump was used in 37 patients during CPB. Hemodynamic changes, content of free hemoglobin, amount and color of urine were monitored during and after CPB. Results: The stable perfusion pressure and bypass flow were maintained in study group. The amount of urine was at the range of 900 ± 200ml. The incidence of macroscopical hematuria or chromaturia was 17.4% in study group, lower than that in control group (89.9%,P<0.01). The content of free hemoglobin in study and control group were 1. 9g/L and 7. 9g/L, respectively(P<0.01). Conclusion: The application of centrifugal pump during CPB is adaptable to patients with high body weight.

关 键 词：离心泵 体外循环 高体重 

分 类 号：R654.1[医药卫生—外科学]