改良超滤对小儿体外循环术后呼吸动力学的影响  

Effect of Modified Ultrafiltration on Pneodynamics after Cardioplmonary Bypass in Children

作　　者：吴旭辉[1] 陈国兴[1] 吴亦志[1] 周耀洪[1] 吴功志[1] 彭从兄[1] 王胜利[2] 

机构地区：[1]温州医学院附属第六医院心胸外科,丽水323000 [2]温州医学院附属育英医院心胸外科

出　　处：《浙江中西医结合杂志》2004年第12期736-738,共3页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的 :观察改良超滤在小儿体外循环手术中对呼吸动力学的影响 ,了解其在小儿体外循环中对肺的保护作用 ,为临床工作中进一步开展改良超滤提供依据。方法 :选择 2 0 0 2年 1 1月～ 2 0 0 3年 7月间行体外循环下矫治的先天性心脏病患儿 2 8例。随机分改良超滤组 1 5例和不进行超滤的对照组 1 3例。对照组用旁气流测量法 ( side stream spirometry,SSS)于转流前、后 ,改良超滤组于超滤结束后 ,分别测定气道平均压 ( Pmean)、胸肺顺应性 ( CL)及气道阻力 ( Raw)。结果 :两组患者Pmean、CL及 Raw均有不同程度改变 ,但改良超滤组变化程度小于对照组 ,两组比较 ,差异有显著性意义。结论 :体外循环手术对肺的损伤是难以避免的 ,小儿体外循环手术中应用改良超滤能减轻体外循环对患儿呼吸动力学造成的影响 。Objective: To observe the effect of modified ultrafiltration on pneodynamics among cardiopulmonary bypass in children, and to investigate its protection on lung of children, in order to provide evidence of developing modified ultrafiltration in clinical treatment. Methods: 28 children suffered congenital heart disease underwent open-heart surgery from 2002,11 to 2003,7 were chosen and divided randomly into experimental group using modified ultrafiltration during and after bypass (MUF group, n =15) and control group ( n =13) of non ultrafiltration during bypass. Side stream spirometry (SSS) was used in observing mean airway pressure (Pmean), thoracic pulmonary compliance (CL) and airway resistance (Raw) in two groups before the operation and immediately after modified ultrafiltration (experimental group) or after bypass (control group). Results: Both groups' mean airway pressure (Pmean), thoracic pulmonary compliance (CL) and airway resistance (Raw) changed differently after operation in two groups. But the extent of change in MUF group was significantly less than that in control group. Conclusion: The damage of the lung caused by Cardiopulmonary bypass is unavoidable. Using modified ultrafiltration in children's open heart operation can reduced the damage and improve the pulmonary function after bypass.

关 键 词：改良超滤 体外循环 术后 呼吸动力学 儿童 

分 类 号：R726.5[医药卫生—儿科]