心肺转流术致未成熟肺损伤及其保护的研究现状  

Immature Lung Injury During Cardiopulmonary Bypass and the Study of Its Protection

作　　者：李庆新[1] 易定华[2] 吕国祯[1] 

机构地区：[1]兰州军区总医院胸心外科,兰州730050 [2]第四军医大学西京医院心血管外科中心

出　　处：《中国胸心血管外科临床杂志》2001年第4期256-258,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：心肺转流术 (CPB)所致未成熟肺损伤 ,是婴幼儿心脏手术后严重的并发症 ,直接影响心脏手术的成功率 ,但其损伤机制及如何有效地施行保护 ,一直是个亟待解决的问题。研究结果发现 ,心肺转流时外源性物质激活补体介导全身炎症是肺损伤的关键 ,中性粒细胞肺内聚集活化是肺缺血 -再灌注损伤的中心环节。白细胞浸润 ,释放大量弹性蛋白酶 ,产生大量的氧自由基 ,破坏肺泡上皮及血管内皮细胞 ,导致肺水肿。婴幼儿未成熟肺因其肺组织表面活性物质少 ,血管内皮细胞通透性高的特点 ,更易出现肺水肿、肺不张 ,引起术后肺功能不全。目前 ,研究的保护措施有药物、表面活性物质和肺动脉灌注等。Immature lung injury during cardiopulmonary bypass (CPB) is a severe post operative complication in infants and neonates and one of main cause of higher peri operative mortality. Its exact mechanism is still unclear and its protective strategy is far from satisfactory at present. Compared with adult lung, immature lung tissue syntheses and secrets less surfactants and has higher vascular permeability. During CPB, complements were activated, neutrophil granulocyte aggregated and activated and large amount of oxygen free radicals were formed. These pathogenesis resulted in injuries to vascular endothelium, alveolar epithelium and pulmonary edema. There had been some methods that could decrease the lung injury during CPB such as medicament, surfactant and pulmonary perfusion and so on.

关 键 词：心肺转流术 未成熟肺 缺血-再灌注损伤 肺保护 

分 类 号：R654.2[医药卫生—外科学]