猪心脏不停跳体外循环期不同温度变化对血液流变性的影响  

Effects of different temperature on hemorrheological parameters in beating heart model of pig during cardiopulmonary bypass

作　　者：黄海清[1] 彭劲松[2] 罗玉忠[3] 陈燕华[1] 涂杰[1] 梁庆璇[1] 黄国勇[1] 

机构地区：[1]广西医科大学第一附属医院导管手术麻醉室,530021 [2]广西医科大学第一附属医院麻醉科,530021 [3]广西医科大学第一附属医院心胸外科,530021

出　　处：《中国现代医药杂志》2013年第6期5-8,共4页Modern Medicine Journal of China

基　　金：广西科学基金资助项目(编号:桂科青0447038)

摘　　要：目的观察猪心脏不停跳体外循环期间温度变化对猪血液流变学指标的影响。方法选择猪龄3~4月、体重20~25kg的广西本地健康杂种猪14只,随机分A、B两组,每组7只。全身麻醉后建立心脏不停跳体外循环实验模型。A组：鼻咽温度降至37℃时停止血液降温,维持鼻咽温度在36℃~37℃时间30min后即行复温并缝合心脏。B组：鼻咽温度降至32℃时停止血液降温,维持鼻咽温度在31℃~32℃时间30min后即行复温并缝合心脏。于转机开始前（T1）、降温到设定值（T2）、低温维持30min（T3）、复温完成（T4）和停机后20min（T5）5个时点,经股动脉采血液标本5ml/次,测定标本中血液流变学指标。结果低、中、高切变率下的全血粘度、红细胞压积（Hct）在两组内T2、T3、T4和T5各时点均低于转流前T1水平（P〈0.05）;高切变率全血还原粘度在两组内T2、T3、T4和T5各时点均低于转流前T1水平（P〈0.05）;A组内T2和T3时点的红细胞刚性指数（IR）低于转流前T1水平（P〈0.05）;低切变率全血还原粘度和中切变率全血还原粘度、红细胞电泳指数、红细胞聚集指数（Arbc）、红细胞变形指数（TK）在两组内和两组间差异均无显著性。结论在建立的心脏不停跳体外循环猪模型中,体外循环期间两组不同变温过程均未呈现明显不利于微循环灌注的血液流变学变化。Objective To observe the effect of different temperature on hemorrheological parameters in beating heart model of pig during cardiopulmonary bypass. Methods A total of fourteen pigs,aged 3~4 months,weight 20~25kg,were randomly divided into two groups （A and B,n=7）. Established the model of beating heart during cardiopulmonary bypass. Group A： when the temperature of nasopharynx decreased at 37℃ to stop cooling down the temperature of the blood,maintained the temperature of nasopharynx at 36℃~37℃ about 30 minutes,and then warmed to normal degree and suture the heart. Group B： when the temperature of nasopharynx decreased at 32℃ to stop cooling down the temperature of the blood, maintained the temperature of nasopharynx at 31℃~32℃ about 30 minutes,and then warmed to normal degree and suture the heart. Blood samples were taken at before cardiopulmonary bypass（T1）, failed to a certain temperature（T2）, the maintain of temperature（T3）, the achievement of the warm up（T4） and 20 minutes after stopping bypass （T5） from the femoral artery about 5ml. Observed the hemorrheological parameters. Results The blood viscosity and Hct of T2 ,T3 ,T4 and T5 were decreased compared to T1 in different shear rate （low,medium and high）,P＆lt;0.05; the blood viscosity of T2 ,T3 ,T4 and T5 were decreased compared to T1 at high shear rate （P＆lt;0.05）; the IR of T2 and T3 were decreased compared to T1 in group A （P＆lt;0.05）; the blood viscosity of low and medial shear rate,the erythrocyte electrophoresis index, Arbc,TK were not significantly different between groups and within group. Conclusion Different temperatures have no significant adverse effects on hemorrheological parameters in beating heart model of pig during cardiopulmonary bypass.

关 键 词：猪 温度 血液流变学 体外循环 

分 类 号：R614[医药卫生—麻醉学]