改良超滤对成人重症心脏瓣膜置换术的影响  

Influence of modified ultrafiltration on the adult severe heart valve replacement

作　　者：盛继红[1] 叶仕新[1] 杨胜生[1] 曾志勇[1] 程先进[1] 

机构地区：[1]解放军南京军区福州总医院心胸外科,福建福州350025

出　　处：《临床军医杂志》2010年第6期904-906,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨改良超滤技术(MUF)在成人重症心脏瓣膜置换术中的影响。方法 50例重症心脏瓣膜病患者随机分为实验组(MUF组,n=25)和对照组(CUF组,n=25),在术中分别采用改良超滤和常规超滤(CUF),对两组术后早期临床资料进行对比研究。结果两组间的红细胞比容(Hct)在术前、超滤前差异无统计学意义(P>0.05),在超滤后MUF组高于CUF组(P<0.01),MUF组术后出血及库血使用均低于CUF组(P<0.05),术后血流动力学较平稳,呼吸机支持时间较短,术后24 h尿量明显减少。但术后ICU滞留时间、病人下床活动时间以及术后出院时间差异无统计学意义(P>0.05)。结论改良超滤可在手术后短时间内浓缩血液,提高Hct,改善肺功能,减少出血和库血使用,但不能改善患者远期预后。Objective To investigate the influence of modified ultrafiltration(MUF)on the adult severe heart valve replacement with cardiopulmonary bypass(CPB).Methods Fifty adult severe patients undergoing valves replacement were randomized into MUF group(n=25)and control group(CUF,n=25).After the application of conventional and modified ultrafiltration respectively,we compared the relevant clinical information between the two groups.Results There were no significant differences in HCT before operation and ultrafiltration between the two groups(P>0.05).After ultrafiltration,HCT in MUF group was higher than that in CUF group(P<0.01).The total postoperative blood loss and the time of mechanical ventilation were significantly less in the MUF group than the control group(P<0.05).The total duration of ICU and hospital staying were similar in both the groups(P>0.05).Conclusion The use of MUF can effectively concentrate the blood,transiently improve pulmonary function and decrease postoperative blood loss as well as postoperative requirement of allogenic blood transfusion in sick adult patients.It did not have any major impact on clinical outcome.

关 键 词：改良超滤技术 成人 重症心脏瓣膜病 心脏瓣膜置换术 heart valve replacement 术后早期 统计学意义 滞留时间 MUF CUF 血流动力学 红细胞比容 远期预后 术后出血 时间差异 临床资料 活动时间 患者 对比研究 手术后 

分 类 号：R82[医药卫生—临床医学]