肺动脉持续灌注对胸腔镜下体外循环心脏手术的肺保护作用研究  

Lung protective effects of continuous perfusion of pulmonary artery on thoracoscopic cardiopulmonary bypass

作　　者：于洪涛[1] 杨晓涵[1] 张锐[1] 陈其龙 王尧 杨建安[1] YU Hongtao;YANG Xiaohan;ZHANG Rui;CHEN Qilong;WANG Yao;YANG Jianan(Department of Cardiology, The Sun Yatsen Cardiovascular Hospital, Shenzhen 518057,China)

机构地区：[1]深圳市孙逸仙心血管医院心血管外科,518057 [2]深圳市孙逸仙心血管医院超声科,518057

出　　处：《心肺血管病杂志》2019年第4期409-411,共3页Journal of Cardiovascular and Pulmonary Diseases

基　　金：深圳市科技计划项目(JCYJ20150402094341896)

摘　　要：目的:探析胸腔镜下体外循环心脏手术进行肺动脉持续灌注的肺保护作用机制。方法:临床选择2016年4月至2017年5月,在本院就诊的二尖瓣置换术患者50例,根据随机对照法分组,分为肺灌注组(n= 25)、对照组(n = 25),肺灌注组在患者体外循环期间予以肺动脉含氧血肺动脉持续灌注,对照组进行二尖瓣常规置换术,比较两组的住院时间、ICU监护时间、术后呼吸机辅助时间、阻断主动脉时间、体外循环时间。比较两组术前、结束CPB时、术后6 h的肺静脉顺应性改变、氧合指数等临床指标。结果:肺灌注组的体外循环时间、住院时间、ICU监护时间、术后呼吸机辅助时间、阻断主动脉时间等临床指标与对照组相比,显著降低,差异有统计学意义(P<0. 05);肺灌注组结束CPB时、术后6 h 的肺静脉顺应性改变、氧合指数等临床指标与对照组比较,显著增高,差异有统计学意义(P<0. 05)。结论:胸腔镜体外循环心脏手术术后出现肺损伤,进行肺动脉含氧血持续灌注可减轻肺损伤。Objective : To explore the lung protective mechanism of continuous perfusion of pulmonary artery under thoracoscopic cardiopulmonary bypass. Methods : 50 patients with mitral valve replacement in our hospital from April 2016 to May 2017 were divided into lung perfusion group(n = 25) and control group(n = 25) according to random control method .Pulmonary perfusion group was given pulmonary artery oxygenated blood and pulmonary artery continuous perfusion during cardiopulmonary bypass.The hospitalization time,ICU monito-ring time, postoperative ventilator assistance time, aortic occlusion time, cardiopulmonary bypass time were com-pared between the two groups.The pulmonary venous compliance and oxygenation index of the two groups were compared before and after CPB and 6 h after operation. Results : There was no significant difference in the time of extracorporeal circulation between the two groups(P>0. 05),but the hospitalization time of the lung perfusion group,the time of ICU monitoring,the auxiliary time of the ventilator after operation,and the interruption of the aortic time were significantly lower than those in the control group, and the difference was statistically significant (P<0. 05).When the lung perfusion group ended CPB,the pulmonary venous compliance and oxygenation index of 6 h after the operation were significantly higher than those in the control group, the difference was statistically significant(P<0. 05). Conclusions: Pulmonary injury occurs after thoracoscopic cardiopulmonary bypass.Continuous perfusion of pulmonary artery oxygenated blood can alleviate lung injury.

关 键 词：肺损伤 肺动脉灌注 体外循环 腹腔镜 保护作用 临床观察 

分 类 号：R54[医药卫生—心血管疾病]