MUF和BUF在小儿心肺转流术中的联合应用  

Combination of balanced ultrafiltration and modified ultrafiltration in pediatric cardiopulmonary bypass

作　　者：王桂龙[1] 张兴梅[2] 胡毅平[1] 吴硕雄[1] 姚冰薇[1] 李明秋[1] 

机构地区：[1]南京医科大学附属无锡第一医院,江苏无锡214002 [2]南京医科大学附属无锡第二医院,江苏无锡214002

出　　处：《东南大学学报（医学版）》2007年第6期461-463,共3页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:比较并评价平衡超滤和改良超滤在小儿心肺转流术(CPB)中的效果。方法:60例先天性心脏病患儿随机分成平衡超滤(BUF)组、改良超滤(MUF)组和BUF联合MUF(B+M)组3组,分别在整个CPB期间、停CPB后和全过程进行超滤。结果:各组临床资料无差异,BUF组在CPB中滤出液体(415±136)ml,MUF组滤出(294±81)ml,B+M组滤出(726±153)ml;BUF组在CPB过程中炎症因子浓度无明显变化,而MUF组则有上升趋势,B+M组在CPB结束时炎症因子浓度明显低于MUF组(P<0.05);MUF组进行超滤时,血细胞比容明显提高,炎症因子浓度有所上升。结论:平衡超滤法能在CPB中维持较低的体内炎症介质浓度;改良超滤法可以在术后迅速浓缩血液,但对降低炎症介质的浓度影响较小;BUF联合MUF在CPB中既可以维持较低的体内炎症介质浓度又能在术后迅速浓缩血液。Objective To evaluates the effect of balanced ultra_filtration,modified ultrafiltration,and combination of balanced uhrafiltration with modified uhrafiltration on inflammatory mediators in children＇s open-heart surgery. Method Sixty children with congenital heart disease were randomly divided into three groups： balanced uhrafihration group （BUF group） ; modified ultrafiltration group （MUF group） ; and balanced ultrafiltration combined with modified ultrafiltration group （ B ＋ M group）. Results Of these groups with similar clinical data the ultrafiltrated volumes were （415 ± 136 ） ml, （ 294 ± 81 ） ml and （ 726 ± 153 ） ml respectively. Tumor necrosis factor （ TNF）, interleukin-8 （ IL-8 ） were measured at the beginning of cardiopulmonary bypass （CPB） ,30 min later,at the cessation of CPB,at the cessation of MUF （ MUF group and B ＋ M group）, and 8 hours postoperatively. During CPB, the concentrations of TNF and IL-8 increased significantly in MUF group and did not change significantly in BUF and B ＋ M groups. In the period of MUF, TNF and IL-8 increased. Conclusion The study shows that uhrafihration can filter out the inflammatory mediators, but only BUF can decrease their concentrations. Moreover, MUF only can condense blood. Combination of BUF and MUF maintains low levels of inflammatory mediators,and postoperatively condenses blood.

关 键 词：超滤法 心肺转流术 炎症介质 

分 类 号：R654.1[医药卫生—外科学]