肺动脉灌注低温肺保护液对合并重度肺高压先天性心脏病患儿的肺保护效果评价  

The Effect of Pulmonary Artery Perfusion with Hypothermic Lung-protective Solution to Congenital Heart Disease Patients with Pulmonary Hypertension

作　　者：林柏松[1] 李玉林[2] 张秀和[1] 李一雷[2] 李哲[1] 

机构地区：[1]吉林大学中日联谊医院心脏外科,吉林长春130033 [2]吉林大学教育部病理生物学重点实验室

出　　处：《中国实验诊断学》2008年第5期616-619,共4页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省科技厅科技发展计划基金资助(200505157)

摘　　要：目的评价体外循环期间肺动脉灌注低温保护液对合并重度肺高压先天性心脏病患儿的肺保护作用。方法将20例合并重度肺高压先天性心脏病患儿随机分为对照组和实验组。实验组在主动脉阻断后经肺动脉灌注低温保护液,对照组则不灌注肺保护液。不同时间点采集外周动脉血,进行中性粒细胞计数,不同时间点检测动脉血氧分压、吸入氧浓度、气道阻力,计算氧指数。结果对照组在升主动脉开放20min中性粒细胞计数较术前明显降低,实验组的中性粒细胞计数在体外循环结束时明显高于术前,实验组与对照组的氧指数在体外循环结束后6h达到最低点,实验组的氧指数在体外循环结束后12h回升接近术前正常水平,而对照组则未回升至术前正常水平。在体外循环结束后0、3、6、12h,实验组的氧指数均明显高于对照组。结论体外循环后存在肺损伤,使用低温肺动脉灌注液可明显减轻合并重度肺高压先天性心脏病患儿的这种肺损伤。Objective The aim was to determine the effect of pulmonary peffusion with hypothermie protective solution on lung function during eardiopulmonary bypass （CPB） .Methods Twenty congenital heart disease patients with pulmonary hypertension were randomly divided into two groups. During CPB, the study group were perfused with 4℃ protective solution, control group were not. Neutrophil counts and PaO2/FiO2 ratio were measured at different time-points. Results In study group, the Neutroplfil counts at the termination of CPB were lower than the prebypass value. In control group, the Neutrophil counts at the 10 vain after removal of aortic cross-clamp were lower than the prebypass value. At each measuring point PaO2/FiO2 ratio of the study group was significantly lfigher fir.an that of the control group （ P 〈 0.05） .The PEA.a]O2 Values of study group were significantly lower than those of control group （ P 〈 0. 001 ） after CPB. The P[A-a]O2 Values of study group after CPB wre no differencr from those before CPB. Conclusion Tiffs study de.monstrated that pulmonary artery peffusion with the hypothermic protective solution can obviously reduce lung injury after eardiopul- monary bypass.

关 键 词：抑肽酶 沐舒坦 肺动脉灌注 肺保护液 体外循环 

分 类 号：R725.4[医药卫生—儿科]