经白细胞滤器过滤后剩余机血的变化及输注后对患者炎症反应的影响  

The clinical study of infusion residual pump blood after CPB processed by leukocyte filter

作　　者：胡金晓[1] 王会颖[1] 龙村[1] 楼松[1] 

机构地区：[1]中国医学科学院阜外心血管病医院体外循环科,北京100037

出　　处：《中国体外循环杂志》2014年第2期96-98,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的研究经白细胞滤器过滤后体外循环(CPB)剩余机血的变化以及输注后对患者炎症反应的影响。方法纳入40例预计不需要输注异体血的患者,随机分为实验组和对照组。实验组CPB停机后即刻使用白细胞滤器过滤剩余机血并输注,对照组剩余机血不处理直接输注,所有患者围手术期没有输注异体血制品。观察患者CPB前、停机时、机血输毕6 h白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)浓度以及胶体渗透压(COP)、游离血红蛋白(FHb)浓度。观察患者CPB前、停机时、机血输毕6 h、术后次晨白细胞(WBC)计数、体温以及气管插管时间。结果实验组机血输毕6 h、术后次晨WBC计数高于对照组。其它观察指标两组差异无显著性。Objective To study the effects of leukocyte filter processed residual pump blood infusion on the systemic inflammatory response and patients＇ recovery.Methods 40 patients were randomly divided into 2 groups.Trial group （filter group） and control group （non filtered group）.Patients requiring heterogenous blood transfusion were excluded.The concentration of interleukin-6 （IL-6）,interleukin-10 （IL-10）,tumor necrosis factor-α（TNF-α）,colloid osmotic pressure （COP）,free hemoglobin （FHb） were measured at the following time points：before CPB,at the end of CPB,6 hrs after the residual blood infusion finished.Patient＇s temperature,leukocyte counts before CPB,at the end of CPB,6 hrs after the residual blood infusion finished and next morning after operation,and mechanical ventelation time were also recorded.The count of platelet,the concentration of FHb and COP of the residual blood were measured.Results The counts of leucocyte increased significantly in trial group at the following time points：6 hrs after the residual blood infusion and first morning after operation.Conclusion We could not demonstrate that infusion residual pump blood after CPB processed with leucocyte filter could inhibit systemic inflammatory response.

关 键 词：体外循环 炎症反应 白细胞滤器 剩余机血 

分 类 号：R654.1[医药卫生—外科学]