低温洗涤红细胞肺保护液对体外循环术后肺保护作用的研究

Lung Protection by Pulmonary Artery Perfusion with Hypothermic and Washed Red Blood Cells Solution After Cadiopulmonary Bypass

目的:探讨体外循环(cardiopulmonarybypass,CPB)术中采用低温洗涤红细胞肺保护液实施肺动脉灌注对肺的保护效果。方法:随机选取20例风湿性单纯二尖瓣病变合并中度肺动脉高压的患者,分为肺动脉灌注组和对照组(每组各10例)。灌注组在主动脉阻断后,经肺动脉根部间断灌注低温洗涤红细胞肺保护液,测定两组患者围术期的机械通气时间、肺血管阻力、白细胞比值(静脉血/动脉血)、肺循环血浆MDA含量。结果:体外循环术后灌注组机械通气时间显著低于对照组(P<0.05);各时点肺血管阻力、白细胞比值(静脉血/动脉血)、肺循环血浆MDA含量均显著低于对照组(P<0.01)。结论:低温洗涤红细胞肺保护液肺动脉灌注对体外循环术后肺损伤有明显的保护作用.

Objective:To evaluate the protective eff ec t of pulmonary artery perfusion with4℃hypothermic and washed red blood cells (RBC)solution on lung function after cardiopulmonary bypass(CPB).Methods:T wenty cases of mitral valve replacement patients with pulmonary hypertension we re randomly divided into the control(n=10)and the perfusion group(n=10 ).The pulmonary artery was in-fused with4℃washed RBC protective solution du ring CPB in the perfusion group.All patients' blood cell counts,plasma MDA an d pulmonary vascular resistance were measured and the time of mechanical ventil ation was obtained as well.Results:The time of mechanical ventilation was sho rter in the perfu-sion group than that in the control group(P<0.05).Neu trophil ratio of vein and artery,plasma MDA,pulmonary vascular resistance dec reased significantly in the perfusion group than in the control group at the ter mination of CPB and1h,24h after CPB(P<0.01).Conclusion:Pulmonary ar tery perfusion with hypothermic and washed RBC solution could protect lung funct ion after cardiopulmonary bypass.