成人体外循环模型中评价不同情况下侧路分流量  

Evaluation of Shunting Flow Differences in Varied Conditions in a Simulated Adult Cardiopulmonary Bypass Model

作　　者：段欣[1] 吉冰洋[2] 刘刚[2] 李青峰[3] 唐跃[4] 于坤[2] 龙村[2] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院,北京100037 [2]中国医学科学院北京协和医学院阜外心血管病医院体外循环科,北京100037 [3]洛阳市中心医院心脏外科,河南洛阳471000 [4]北京协和医学院中国医学科学院阜外心血管病医院心脏外科,北京100037

出　　处：《中国胸心血管外科临床杂志》2011年第1期49-53,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的研究在常温成人体外循环(CPB)模型中,评估不同状态下侧路的分流量。方法按4种不同的分流状态模拟成人体外循环,主要包括:人工心肺机、变温水箱、体外循环管路、成人膜式氧合器和动脉滤器。状态1:动脉滤器排气管开放状态;状态2:滤器排气管和6.5 mm直径管连接血液超滤器开放状态;状态3:滤器排气管和5 mm直径管连接血液超滤器开放状态;状态4:滤器排气管和含血心脏停搏液侧路开放状态。使用超声流量计记录氧合器前和滤器后流量,同时记录动脉滤器后以及滤器分流管的压力。结果在状态1下,当泵流量不变时,分流率随着滤器后压力升高而逐渐升高;当滤器后压力不变时,分流率随着泵流量的增加而逐渐降低;当泵流量恒定时,动脉滤器排气管压力随着滤器后压力升高而升高。在状态2下的分流量最大;状态3和状态4分流量差别不大;在4种状态下,分流管压力均小于滤器后压力。结论在不同分流侧路开放状态下,会产生从动脉管路的分流;在低流量和高滤器后压力状态下,分流量增加明显。在动脉滤器后安装超声流量计有助于精确监测灌注流量变化。Objective To evaluate different shunting flow in varied conditions in a simulated adult cardiopulmonary bypass（CPB） model under normothermia. Methods We established the pseudo adult patient undergoing CPB at four different shunting states with devices of heart-lung machine,heat-cooler,an adult membrane oxygenator and arterial filter.In state 1,purge line of the arterial filter was open alone;In state 2,purge line combined with 6.5 mm tubing hemoconcentrator shunting was open;In state 3,purge line combined with 5 mm tubing hemoconcentrator was open;In state 4,purge line combined with blood cardioplegia shunting was open.The flow of pre-oxygenator and post-filter was recorded with ultrasonic flowmeter,and the pressure of purge line and post-arterial filter was also detected. Results At state 1,when the pump flow was invariable,the percentage of the shunting flow increased with the increase of post-filter pressure.However,when the post-filter pressure was constant,the percentage of the shunting flow decreased with the increase of the pump flow.The purge line pressure increased with the increase of the post-filter pressure at a constant pump flow under state 1.The shunting flow of state 2 was the largest among all the four states.The shunting flow of state 3 was similar to that of state 4.All the purge line pressure was lower than the post-filer pressure of the circuit in the four states. Conclusion Under states of different shunting opening, different degrees of blood flow are diverted away from the arterial line.The shunting flow increases at a lower pump flow and a higher post-filter pressure.A flow probe located in the post-filter line may be necessary to monitor realtime arterial flow.

关 键 词：体外循环 分流 成人 

分 类 号：R654.1[医药卫生—外科学]