新型闭式体外循环系统临床应用初探  

The Clinical Application of A New Type of Closed Extracorporeal Circulation System

作　　者：曾庆东[1] 刘刚[1] 李勇男[1,2] 孙燕华[1] 刘铭月 吉冰洋[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管疾病国家重点实验室体外循环中心,北京市100037 [2]兰州大学第二临床医学院兰州大学第二医院,兰州市730000

出　　处：《中国分子心脏病学杂志》2016年第2期1628-1632,共5页Molecular Cardiology of China

摘　　要：目的构建一种新型闭式体外循环系统,并对其安全性及有效性评价。方法选取16例接受体外循环辅助下冠状动脉旁路移植术患者,随机分为两组:闭式体外循环组(n=8,采用闭式体外循环)和常规体外循环组(n=8,采用常规体外循环)。分别记录两组患者的一般资料,血常规及血液生化指标等临床数据。分别于术前(T0)、体外循环开始后30min(T1)、主动脉开放后15min(T2)、术后4小时(T3)、术后24小时(T4)留取动脉血样本。于Tl、T2时间点检测动脉血气;所有时间点血液标本均检测游离血红蛋白,并检测白介素-6,血浆凝血酶原片段-2,纤溶酶-抗纤溶酶复合物和血小板因子-4。结果所有纳入研究患者,术中均未发生体外循环事故,动脉血气结果显示,两组患者体外循环期间动脉血氧分压及二氧化碳分压水平均在正常范围之内,且组间均无明显统计学差异。两组患者围术期血红蛋白、白细胞及血小板数量,谷丙转氨酶、尿素氮、肌酐水平变化组间均无明显统计学差异。游离血红蛋白数值经重复测量设计的方差分析检验,组间比较,F=1.513,P=0.239,组间无统计学差异。炎性因子检测结果,差异均无统计学意义。结论成功构建一种安全有效新型闭式体外循环系统。Objective To construct a new type of closed extracorporeal circulation system and evaluate its safety and efficacy.Methods There were 16 patients recuited receiving coronary artery bypass grafting assisted by cardiopulmonary bypass.Patients were randomized into two groups：the closed extracorporeal circulation system group（n=8）and the conventional extracorporeal circulation system group（n=8）.Data including patients＇ general information,routine blood test and hematological biochemical index were separately recorded.Arterial blood samples were collected respectively before operation（T0）,30 min after the beginning ol＇CPB（T1）,15 min after aortic opening（T2）,4 hours after operation（T3） and 24 hours after operation（T4）.Arterial blood gas was detected at T1 and T2 time points;Blood samples at all time points were tested for free hemoglobin,interleukin-6,plasma prothrombin fragment-2,plasmin-antiplasmin complex and platelet factor-4.Results Among all the patients recruited,there occurred no accidents during the CPB.Arterial blood gas results showed that the oxygen and carbon dioxide partial pressure levels of the two groups were within the normal range,and there existed no statistical significant difference.The perioperative hemoglobin,white blood cell,platelet count,alanine aminotransferase,urea nitrogen and creatinine levels also showed no significant difference between the two groups.The variance analysis of free hemoglobin was tested by repeated measurement.F=1.513,P=0.239,thus no statistical difference existed between the two groups.The test of inflammatory factor also showed no difference.Conclusions a new type of closed extracorporeal circulation system with good efficacy and safety has been successfully established.

关 键 词：体外循环 闭式系统 心脏外科 

分 类 号：R654.1[医药卫生—外科学]