心脏停跳1h猪供肺与正常猪供肺经体外肺灌注4h后肺功能比较  

Comparison of donor lung function after 4hof ex vivo lung perfusion between pigs after 1hcardiac arrest and normal pigs

作　　者：刘晓飞[1] 丁志丹[1] 秦智[1] 赵凯 廖秋明[2] 赵高峰[1] LIU Xiao-fei;DING Zhi-dan;QIN Zhi;ZHAO Kai;LIAO Qiu-ming;ZHAO Gao-feng(Department of Lung Transplantation Surgery/Thoracic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Igelosa Life Science Center,Lund University,Lund 22002,Sweden)

机构地区：[1]郑州大学第一附属医院肺移植外科/胸外科,河南郑州450052 [2]瑞典隆德大学附属Igelosa生命科学实验中心,瑞典隆德22002

出　　处：《中华实用诊断与治疗杂志》2022年第12期1215-1218,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省高等学校重点科研项目(20A320059)。

摘　　要：目的比较失血性休克心脏停跳1h猪供肺与正常猪供肺经体外肺灌注4h后肺功能。方法6只健康瑞典家猪随机分为心死亡组和对照组各3只,心死亡组开放颈动脉制备失血性休克心脏停跳模型,动脉收缩压<10mm Hg后开始计时,26℃室温静置1h后正中开胸,4℃Perfadex plus灌注液灌注后获取供肺。对照组全身肝素化后正中开胸,4℃Perfadex plus灌注液灌注后获取供肺。应用X-VIVO体外肺灌注系统配合无细胞Steen灌注液进行离体后肺灌注维持4h,记录2组供肺灌注1、4h时肺动态顺应性、肺动脉压、肺循环阻力、氧合指数。结果心死亡组供肺灌注4h时肺动态顺应性[(39.60±1.73)L/cm H_(2)O]、肺动脉压[12(11,12)mm Hg]、肺循环阻力[182(182,182)(dyn·s)/cm^(5)]均低于灌注1h时[(50.77±1.64)L/cm H_(2)O、14(13,15)mm Hg、430(430,468)(dyn·s)/cm^(5)](P<0.05),肺氧合指数[419(419,423)mm Hg]与灌注1h时[418(418,422)mm Hg]比较差异无统计学意义(Z=-1.124,P=0.261)。对照组供肺灌注4h时肺动态顺应性[(39.03±1.27)L/cm H_(2)O]、肺循环阻力[186(180,186)(dyn·s)/cm^(5)]均低于灌注1h时[(50.23±1.29)L/cm H_(2)O、456(430,476)(dyn·s)/cm^(5)](P<0.05),肺动脉压[11(11,13)mm Hg]、肺氧合指数[423(419,432)mm Hg]与灌注1h时[14(13,14)、420(418,432)mm Hg]比较差异均无统计学意义(P>0.05)。2组供肺灌注1、4h时肺动态顺应性、肺动脉压、肺循环阻力、肺氧合指数比较差异均无统计学意义(P>0.05)。结论失血性休克心脏停跳后猪供肺在26℃室温静置1h,经体外肺灌注4h后供肺功能良好。Objective To compare the donor lung function after 4hof ex vivo lung perfusion between pigs with hemorrhagic shock after 1hcardiac arrest and normal pigs.Methods Six healthy Swedish domestic pigs were randomly divided into cardiac death group and control group,with three pigs in each group.The hemorrhagic shock induced cardiac arrest models were established by opening the carotid artery in cardiac death group,the timing started when arterial systolic blood pressure was<10mm Hg,the chest was opened in the middle after staying at 26℃room temperature for 1h,and the donor lungs were obtained after perfusion with 4℃Perfadex plus perfusion solution.In control group,the chest was opened after systemic heparinization,and the donor lungs were obtained after perfusion with 4℃Perfadex plus perfusion solution.Ex vivolung perfusion was maintained for 4hwith cell-free Steen solution by X-VIVO extracorporeal pulmonary perfusion system.The dynamic compliance,pulmonary artery pressure,pulmonary circulatory resistance and oxygenation index were recorded in two groups after 1and 4hof lung perfusion.Results In cardiac death group,the dynamic compliance,pulmonary artery pressure and pulmonary circulatory resistance were lower after 4hof lung perfusion[(39.60±1.73)L/cm H_(2)O,12(11,12)mm Hg,182(182,182)(dyn·s)/cm^(5)]than those after 1hof lung perfusion[(50.77±1.64)L/cm H_(2)O,14(13,15)mm Hg,430(430,468)(dyn·s)/cm^(5)](P<0.05),and the pulmonary oxygenation index showed no significant difference after 4hof lung perfusion[419(419,423)mm Hg]compared with that after 1hof lung perfusion[418(418,422)mm Hg](Z=-1.124,P=0.261).In control group,the dynamic compliance and pulmonary circulatory resistance were lower after 4hof lung perfusion[(39.03±1.27)L/cm H_(2)O,186(180,186)(dyn·s)/cm^(5)]than those after 1hof lung perfusion[(50.23±1.29)L/cm H_(2)O,456(430,476)(dyn·s)/cm^(5)](P<0.05),and the pulmonary artery pressure and pulmonary oxygenation index showed no significant differences after 4hof lung perfusion[11(11,13),423(419,432)

关 键 词：肺移植 心死亡供体 体外肺灌注 家猪 

分 类 号：R655.3[医药卫生—外科学]