不同心脏病人心肺转流期间肺顺应性的动态观察

The Changes in Pulmonary Compliance during CPB in Patients with DiHerent Cardiac Diseases

本文观察了两组心内直视手术病人心肺转流前后肺顺应性的动态变化。结果发现先心组病人（ｎ＝１４）转流期间胸肺顺应性（Ｃｓ）和动态肺顺应性（Ｃｄ）均显著降低（Ｐ＜０．０１），停机２０ｍｉｎ和术毕时仍低于转流前（Ｐ＜０．０１）；瓣膜组（ｎ＝１１）Ｃｓ、Ｃｄ值转流期间亦同样降低（Ｐ＜０．０１），但转流后期至术毕渐回升至对照水平（Ｐ＞０．０５）。认为两类病人不同的肺部病理生理特点是造成转流中、后期肺顺应性呈不同变化的基础。体外循环本身可造成两类病人肺顺应性的降低，引起上述变化的确切因素仍待进一步探讨。

he changes of pulmonary compliance during and after CPB were investigated in two groups of cardiac pa-tients.The results showed that in congenital cardiac group the pulmonary thoracic compliance(Cs)and dynamiccompliance(Cd) decreased significantly(P<0. 01)during CPB;Cs,Cd maintained at the lower level at 20 min afterCPBand the end of operation(P<0.01). Similar declines of Cs and Cd during CPB were also observed in the groupof valve replacement patients(P<0.01),but from late period of CPB to the end of operation,Cs and Cd returnedgradually to the control level(P> 0.05).It is concluded that the diffenent changes of pulmonary compliance peri-CPB may be caused by different pathological damages of the lungs in two group patients.The related factors lead-ing to the decrease of pulmonary compliance during CPB need to be studied further.