房间隔缺损和室间隔缺损修补术——围体外循环心脏直视手术血液流变特性的变化

Changes of Blood Rheological Properties by Open Heart Surgery with Extracorporal Circulation

本文对49例房、室间隔缺损修补病例在围手术期的血液流变特性及变化进行了连续测定,结果表明: 1.单纯房间隔缺损(ASD)和单纯室间隔缺损(VSD)病例在围手术期具有相同的血液流变特征; 2.术前,该类病例的血液流变参数基本上在正常范围,提示该类心血管畸形不会对患者血液流变特性发生重大影响; 3.术中,患者血液流变参数的变化,如全血粘、弹参数和血细胞计数指标的下降和RBC刚度指数的上升等,主要反映了血液稀释和人工心肺机的影响; 4.术后,患者血液流变特性变化在时间上大致与由于体外循环心脏直视手术引起的急性时相反应一致。 因此,单纯ASD和单纯VSD病例在围手术期血液流变特性的变化,事实上反映了体外循环心脏直视手术本身对患者血液流变特性的影响,所得结果可作为研究其他需行体外循环心脏直视手术的病例的参考。

49 cases of atrial septal defect (ASD) repair and ventricular septal defect (VSD) repair had been observed continuousely with hemorheological methods in 6 aspects (84parameters) duing perioperative period of open heart surgery.The results of simple ASD & VSD cases measured show:A. the two kinds of diseases have the same hemorheological characteristics during perioperation;B. before operation, almost all of the hemorheological parameters are normal; that implys the diseases may not interfere significantly in patients' hemorheological properties;C. during operation, the changes of patients' hemorheological properties, such as the reduction of blood viscosity, blood viscoelasticity and counting of blood cell, as well as the increasement of erythrocyte rigidital index etc, mainly are induced by hemodilution and artificial heart-lung machine; D. after operation, the changing rules of patients' hemorheological properties roughly match with those of acute phase reactions induced by open heart surgery with extracorporeal circulation.The hemorheologial variation of simple ASD & VSD reqair cases reflect, in fact, the influence of open heart surgery itself to the patients' hemorheological properties. So it is of universal significance to carry on these researches further. The mentioned results can be used as reference.