体外循环搏动灌注对心肾功能及脉图参数的影响  

Study on Biological Indexes and Pulse Parameters in Heart Disease Patients Based on Pulsatile Perfusion

作　　者：刘樱[1] 吴宏进[2] 张志枫[3] LIU YingI WU Hongjing ZHANG Zhifeng(Shanghai Research Institute of Aeupunture and Meridian, Shanghai 200032, China Longhua Hospital Affiliated to Shanghai University of TCM, Shanghai 200032, China Shanghai University of TCM, Shanghai 200032, China)

机构地区：[1]上海市针灸经络研究所,上海200030 [2]上海中医药大学附属龙华医院,上海200030 [3]上海中医药大学,上海201203

出　　处：《辽宁中医杂志》2017年第10期2039-2041,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81173200)

摘　　要：目的:观察体外循环心脏手术搏动灌注对患者肝肾功能和脉图参数的影响。方法:在CPB下手术治疗的心脏病患者88例,主动脉阻断期间搏动灌注组应用人工心肺机自身的滚压泵通过转速改变形成搏动血流进行灌注,脉搏波为三峰(双峰)波形模式;于术前及术后24 h抽取静脉血检测肌酐、尿素氮、乳酸脱氢酶、谷草转氨酶等指标,并采集术前及术后脉搏图。对数据结果进行比较分析。结果:术后肌酐、尿素氮、乳酸脱氢酶、谷草转移酶显著高于术前,但均在正常范围之内,且血肌酐与血尿素氮的比值无显著差异(P>0.05),但术后比值与术前比较,呈下降趋势。手术后脉图参数h1显著高于术前,术后w/t显著低于手术前。结论:(1)搏动灌注可以明显改善患者的心肾功能,有助于减少术后并发症;(2)搏动灌注可以降低外周血管阻力,维持血液动力。Objective：To observe the effect of pulsatile perfusion on cardiac and renal function in patients undergoing cardiac surgery with cardiopulmonary bypass（CPB）.Methods：A total of 88 heart disease patients under CPB surgical treatment applied artificial heart lung machine own rolling pump through the change of speed to form pulsatile blood flow perfusion and the pulse wave was three（Shuangfeng） waveform model.Respectively before and 24 hours after operation,changes of serum creatinine and urea nitrogen,lactate dehydrogenase,aspartate aminotransferase and the pulse indexes were detected.And then we made a comparison and analysis for them.Results：The postoperative serum creatinine,urea nitrogen,lactate dehydrogenase and aspartate aminotransferase were significantly higher than those before operation while they were within the normal range.There was no significant difference between serum creatinine and urea nitrogen（P〈0.05）,but the postoperative ratio showed a downward trend comparing with the preoperative ratio.The pulse parameters h1 and w/t after operation were significantly higher than that before operation,and the postoperative w/t was significantly lower than that before operation.Conclusion：（1）Pulsatile perfusion could obviously improve the heart and kidney function of the patients,and it is helpful to reduce the postoperative complications.（2）Pulsatile perfusion could reduce peripheral vascular resistance and maintain blood dynamics.

关 键 词：脉图参数 体外循环 搏动灌注 

分 类 号：R241.19[医药卫生—中医诊断学] R654.1[医药卫生—中医临床基础]