体外循环冠状动脉搭桥术中常规超滤的应用  

Clinical effects of ultrafiltration used in cardiopulmonary bypass(CPB) coronary artery bypass grafting

作　　者：熊际月[1] 陈界名[1] 杨璨宇[1] 

机构地区：[1]四川大学华西医院麻醉科,成都610041

出　　处：《现代预防医学》2012年第19期5121-5123,共3页Modern Preventive Medicine

摘　　要：目的探讨体外循环冠状动脉搭桥术中常规超滤的应用价值。方法将60例体外循环冠状动脉搭桥的患者随机分为试验组(n=30)和对照组(n=30)。试验组在体外循环中应用持续超滤,对照组作常规体外循环,不应用超滤。两组分别在转流前、主动脉阻断后、转流结束前抽取患者动脉血液样本,测定红细胞压积、血红蛋白、血小板计数、血浆胶体渗透压等指标,并进行术后出血量和输血量的比较。结果与对照组相比,试验组患者的红细胞压积、血红蛋白、血小板计数、血浆胶体渗透压在转流结束前均有显著提高,术后呼吸机辅助时间缩短、术后出血量减少,差异有统计学意义。结论体外循环中采用超滤,可有效提高血浆胶体渗透压,减少呼吸机的使用时间;提高红细胞压积、血红蛋白;提高了血小板计数和血浆蛋白的浓度。OBJECTIVE To explore clinical effects of conventional ultrafiltration used in cardiopulmonary bypass（CPB） coronary artery bypass grafting.METHODS 60 patients of coronary artery bypass grafting under CPB were randomly divided into test group（n = 30） and control group（n = 30）.Ultrafiltration was used in test group,and without it in control group.Arterial blood samples were collected to measure hematocrit,hemoglobin,platelet and plasma colloid osmotic pressure during the following observation times：beginning and end of CPB,aortic cross-clamping.Compared the amount of bleeding and transfusion between the two groups.RESULTS Compared to the control group,hematocrit,hemoglobin,platelet and plasma colloid osmotic pressure of patients in test group had significantly improved.Time of postoperative mechanical ventilation and amount of hemorrhage both significantly reduced.CONCULSION Application of ultrafiltration in CPB is helpful to improve hematocrit,hemoglobin,platelet and plasma colloid osmotic pressure of patients,and reduce time of postoperative mechanical ventilation and amount of hemorrhage.

关 键 词：体外循环 冠状动脉搭桥 超滤 

分 类 号：R654.1[医药卫生—外科学]