犬肺移植围术期血流动力学与血气的变化  

Changes of hemodynamics and blood-gas in the canine lung transplantation

作　　者：孟辉[1] 陈钢[1] 刘高望[2] 申洪[3] 杨锡耀[1] 蔡瑞君[1] 穆峰[1] 

机构地区：[1]中国人民解放军第一军医大学南方医院胸心外科,广东广州510515 [2]中国人民解放军第一军医大学南方医院麻醉科,广东广州510515 [3]中国人民解放军第一军医大学南方医院病理学教研室,广东广州510515

出　　处：《中国急救医学》2003年第6期382-383,共2页Chinese Journal of Critical Care Medicine

基　　金：广东省卫生厅高难高新医疗资助项目 (C2 0 0 0 5 9)

摘　　要：目的　观察犬肺移植术中肺动脉开放前后血流动力学与血气的变化。方法　供受体各 6只健康成年犬 ,4℃改进EC液单次肺动脉灌注获取供肺 ,受体行一侧全肺切除后植入移植肺 ,肺动脉开放前后经右侧股动脉和颈内静脉插管测血流动力学及血气变化。结果　肺动脉开放后MPAP、PVR、SVR和RVSW与术前相比升高和CO、LVSW下降有显著性意义 (P<0 0 5 ) ;与开放时相比 ,PCO2 、AB、T -CO2 有非常显著性意义 (P <0 0 1 ) ,BE有显著性意义 (P <0 0 5 )。肺动脉开放时与术前相比 ,PCO2 有非常显著性意义 (P <0 0 1 )。结论　犬单肺移植可引起肺动脉压升高和体循环功能紊乱 ;Objective To investigate the changes of hemodynamics and blood-gas in the lung transplantation in terms of the pulmonary artery being disparked up and down.Methods Twelve healthy canines that were randomly divided into donor and recipient(n=6)respectively and were anesthetized.The donors were rooted in pulmonary perfusion with single flush and improved Euro-Collins solution(iECS) at 4℃.The recipient was performed unilateral pulmonary pneumonectomy before the donor-lung being transplanted,simultaneously via the intubatton of starboard femoral artery and internal jugular vein mensurated blood-gas and hemodynamics.Results The canines in pulmonary artery disparking behind showed increase in the MPAP,PVR,SVR,RVSW(P<0 05) and lowered in the CO,LVSW(P<0 01) compared with the baselines,which showed in the PCO 2,AB,T-CO 2(P<0 01) and BE (P<0 05) compared with the artery disparking,then there was significant difference in PCO 2(P<0 01) between the disparking and the baselines.Conclusion Hemodynamics became unstable after single lung transplantation,and hypothermia might be deteriorated.The main factors were that the donor was obtained reasonably and delt with according to the changes of hemodynamics and blood-gas in recipient transplant lung.

关 键 词：肺移植 血流动力学 缺血再灌注 肺动脉 

分 类 号：R655.3[医药卫生—外科学]