改良超滤在婴幼儿心内直视手术中的临床应用  

Modified ultra-filtration on recovery of infants after open heart surgery

作　　者：石广永[1] 张供[1] 李跃华[1] 

机构地区：[1]山东大学齐鲁医院心脏外科,济南250012

出　　处：《山东大学学报（医学版）》2008年第6期628-630,共3页Journal of Shandong University:Health Sciences

摘　　要：目的探讨常规超滤(conventional ultrafiltration,CUF)和改良超滤(modified ultrafiltration,MUF)在婴幼儿心脏直视手术中应用及对术后恢复的影响。方法22例先天性心脏病患儿随机分为改良超滤组(M组)和常规超滤组(C组)。分别于术终采桡动脉血,测定红细胞压积(HCT)、血红蛋白浓度(HGB)、血小板计数(PLT)、血浆胶体渗透压(COP)、尿素氮(BUN)、肌酐(Cr);术后不同时点的肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及补体C3、C4水平;并记录术后2 h内的尿量,两组进行比较。结果两组患儿术终HCT、HGB、PLT、COP差异有统计学意义(P<0.05);体外循环后各时点观察组患儿血清TNF-αI、L-6I、L-8水平MUF组均低于CUF组(P<0.05),而C3、C4差异无统计学意义(P>0.05)。结论MUF可以浓缩血液,减轻水肿,降低体外循环术后患儿血清某些炎性介质的水平,减少术后肾脏的水负荷。Objective To investigate the effects of modified ultra-filtration on cytokines after open heart surgeries in infants. Methods A total of 22 patients with congenital heart diseases were randomly divided into the modified ultra-filtration（MUF）group and the conventional ultra-filtration（CUF） group. Blood specimens taken from the radial artery were determined for HCT, PLT, COP, BUN and Cr levels at the end of surgery. Also serum levels of TNF-α, IL-6, 8 and C3, C4 were determined at 0, 3 and 24 h after the operations. And the trrine volume 2 h after operations was recorded. Results The HCT, PLT and COP levels were significantly different between the two groups（ P 〈 0.05）, and the TNF-α and IL-6, 8 levels were significantly lower in the MUF group than in the CUF group（ P 〈 0. 05）, but the C3 and C4 levels were not significantly different between the two groups（ P 〉 0. 05）. Conclusion Modified ultra-filtration could decrease the inflammatory response and the kidney＇s water load after open heart surgeries in infants.

关 键 词：改良超滤 先天性心脏病 婴幼儿 心内直视手术 

分 类 号：R541.1[医药卫生—心血管疾病]