异氟醚预处理对猪心肺联合移植术后肺循环的影响

Effect of isoflurane preconditioning on pulmonary circulation of swine after combined transplantation of heart and lung

目的观察异氟醚预处理对猪心肺联合移植后血液动力学的影响。方法健康猪20只,随机分为供体猪(n=10)和受体猪(n=10),受体猪再随机分为异氟醚组(n=5)及对照组(n=5),供体心肺均由4℃Eu-ro-Collni液保存20～30min后移植入受体猪胸腔,术中异氟醚组1.16%异氟醚持续吸入(从切皮开始至心肺切下停止)加戊巴比妥钠维持麻醉,哌库溴铵维持肌松。对照组仅使用戊巴比妥钠维持麻醉,哌库溴铵维持肌松。结果两组猪在心脏复跳后半小时内MAP,CO与术前基础值相比均有明显降低(P<0.01),而PAP,PCWP,CVP,HR则较移植前显著升高(P<0.01)。异氟醚组心脏复跳后30min内HR,MAP,CO与对照组相比较无明显差异(P>0.05),而异氟醚组的PAP,PCWP,CVP却较对照组明显降低(P<0.05)。结论异氟醚吸入预处理对心肺移植后的肺循环改变具有一定的保护作用。

To study the effect of Isoflurane preconditioning on the pulmonary circulation of swine after combined transplantation of heart and lung. Twenty healthy swine were randomly assigned to donor swine (n =10) and recipient swine (n =10). Then recipient swine were individed into Isoflurane group (n =5) and controlled group (n =5). Donor heart and lung were flushed with 4℃ Euro-Collin's solution and stored in the same solution for 25～30 minutes,and then transplanted into recipient swines. Isoflurane group were anesthetized with Isoflurane、pentobarbital sodium and pipecuronium. But controlled group just were anesthetized with pentobarbital sodium and pipecuronium. The hemodynamics were monitored during the whole procedures. MAP and CO were significantly decreased (P <0.01) but PAP, PCWP, CVP, HR were significantly increased (P <0.01) after heart and lung transplantation than those before the transplantation in both groups. PAP, PCWP and CVP were significantly decreased in Isoflurane group than those in controlled group after combined transplantation of heart and lung(P <0.05). [Conclusion] Isoflurane preconditioning can help to maintain the pulmonary circulation of the recipient after combined transplantation of heart and lung.