HA330-Ⅱ树脂血液灌流器在急性A型主动脉夹层围手术期的临床应用研究  

Study of clinical application on HA330-Ⅱresin hemoperfusion device in acute type A aortic dissection during perioperative period

作　　者：匡智明 刘远飞[1] 匡小兰 张胜睿[1] 朱运林[1] KUANG Zhiming;LIU Yuanfei;KUANG Xiaolan;ZHANG Shengrui;ZHU Yunlin(Ganzhou People′s Hospital,Ganzhou 343100;Taihe County People′s Hospital,Taihe 343700,China)

机构地区：[1]赣州市人民医院,江西赣州343100 [2]泰和县人民医院,江西泰和343700

出　　处：《华夏医学》2023年第2期135-139,共5页Acta Medicinae Sinica

基　　金：江西省卫生健康委员会科技计划(202212460)。

摘　　要：目的:探究HA330-Ⅱ树脂血液灌流器在急性A型主动脉夹层(ATAAD)围手术期的临床应用效果。方法:选取84例ATAAD患者,根据治疗方法不同进行分组,心肺转流(CPB)+深低温循环(DHCA)治疗为常规组(39例),CPB+DHCA+血液灌流器治疗为试验组(45例)。比较两组术前(T_(0))及术后2 h(T_(1))、12 h(T_(2))、24 h(T_(3))的炎性情况,凝血功能及并发症发生率和死亡率。结果:试验组T_(1)、T_(2)、T_(3)的CRP、IL-6、IL-8以及T_(3)的TNF均低于常规组,两组比较差异有统计学意义(P<0.05);两组T_(1)的APTT、PT上升,FIB下降,T_(2)、T_(3)的APTT、PT、FIB恢复良好,各时段比较无统计学差异(P>0.05);试验组术后AKI、ARDS发生率及死亡率均低于常规组(P<0.05)。结论:HA330-Ⅱ树脂血液灌流器在ATAAD围手术期可减低炎性程度,降低并发症发生率与死亡率,改善整体预后。Objective:To study the clinical effect of HA330-Ⅱresin hemoperfusion device in acute type A aortic dissection(ATAAD)during perioperative period.Methods:84 patients with ATAAD were divided into the conventional group(39 patients)and experimental group(45 patients).The conventional group were treated with cardiopulmonary bypass(CPB)and deep hypothermic circulatory arrest(DHCA),and the experimental group were trested with CPB,DHCA and hemoperfusion device.The inflammatory condition,coagulation function,complications and mortality of the two groups were compared before operation(T_(0)),and 2 h(T_(1)),12 h(T_(2)),24 h(T_(3))after operation.Results:The CRP,IL-6,IL-8 and TNF of T_(1),T_(2),T_(3)and TNF in T_(3)in the experimental group were lower than those in the conventional group,with a statistically significant difference(P<0.05).APTT and PT at T_(1)increased,while FIB decreased in the two groups.APTT,PT and FIB at T_(2),T_(3)gradually recovered to preoperative levels,showing no statistically significant difference in each time period(P>0.05).The incidence and mortality of AKI,ARDS and mortality in the experimental group were lower than those in the conventional group(P<0.05).Conclusion:HA330-Ⅱresin hemoperfusion device in ATAAD can decease inflammation,reduce the incidence of complications and mortality,improve the overall prognosis.

关 键 词：血液灌流 急性A型主动脉夹层 HA330-Ⅱ 心肺转流 深低温循环 

分 类 号：R473.6[医药卫生—护理学]