自制气动左心辅助泵的血流动力学及血液相容性研究  

Investigation on hemodynamics and blood compatibility of domestic pneumatic left ventricular assistant pump

作　　者：贺涛[1] 易定华[1] 刘金成[1] 徐学增[1] 

机构地区：[1]第四军医大学西京医院心血管外科,陕西西安710032

出　　处：《西南国防医药》2006年第1期17-19,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的：应用自制气动左心辅助泵进行动物实验，通过对血流动力学及血液破坏情况的研究，探讨该泵的性能及其血液相容性。方法：健康山羊10只，体重（35．3±5．5）kg。从左心房至升主动脉问转流，进行左心辅助，压缩比控制在0．38～0.42，辅助频率为6次／min，流量为2～3L／min。于辅助前至辅助后72h共6个时间点，监测血流动力学指标，并同时行血气分析，测量血浆中游离血红蛋白含量（FHB）、纤维蛋白原含量（FIB）及炎症介质IL-6、IL-8、TNF—α的变化。结果：本组山羊LVAD时间85±12h。在辅助循环过程中，动物血压、中心静脉压维持稳定，尿量正常，无血色素尿。在LVAD的24h，动物体内FHB及IL-6、IL-8、TNF-α炎性介质水平均逐渐升高，至辅助后24h分别达到峰值（0．522＋0．32）mg／ml，（84±2）pg／ml，（102±8）pg／ml，（79±3）pg／ml，与辅助前水平有统计学显著性差异（P〈0．01）。但心脏辅助转流48h后，各组FHB及IL-6、IL-8、TNF—α水平也逐渐降低，至辅助后72h基本降至术前水平，与辅助前无统计学差异（P〉0．05）。HCT和纤维蛋白原含量辅助前后未发生明显变化。结论：自制气动左心辅助泵在保证适当的压缩比、辅助频率和流量的情况下能有效地维持血流动力学稳定，并且血液相容性好。Objective：To investigate the performanoe and blood compatibility of domestic pneumatic left ventrieular assistant pump（LVAD） in goats, Methods. Ten healthy goats weighted（35. 3±5. 5） kg were implanted with domestic pneumatic left ventricular pump. The blood of these animals was assisted circulating from left atrium to ascending sorta with systolic time percentage of 0. 38 to 0. 42, supporting rate of 60 beat/min and pump flow of 2 to 3 L/min. Hemodynamics and serum concentrations of free hemoglobin（FHb）, fibrinogen（Eib）, IL- 6, IL- 8, TNF-β were measured from preoperation to 72 h after the assistance. Results： The mean survival time of goats with LVAD was 85±12 h. During the circulation of LVAD, their MAP and and were stable, urination was normal without hemoglobin. The levels of sertum FHb, IL- 6, IL- 8 and TNF βincreased gradually in the goats with LVAD and resched peak values of （0. 522±0. 32）mg,/ml, （84±2）pg/ml, （102±8）pg/rrd and（79±3）pg/ml, respectively at 24 h after LVAD, and were differeat distinctly from those of the preoperation（P〈0. 01）. Then these parameters returned to baseline at 72 h after LVAD. There were no obvious changes of HCT and Fib during the experiment Conclusion： With proper systofic time percentage, rate and flow, the domestic pneumatic left ventricular pump can effectively maintain stable hemodynamics and show good blood compatibility.

关 键 词：左心辅助 血流动力学 血液相容性 

分 类 号：R541[医药卫生—心血管疾病]