灌洗液红细胞计数与肺保护液量相关关系的实验研究

The relativity of the amount of lavage fluid and the number of red blood cells in lavage fluid in lung transplantation.

目的研究灌注液的量与灌洗液红细胞计数的相关关系,进而评估肺保护的效果。方法五指山猪10头,麻醉后,切开主肺动脉,以低钾灌注液(LPD)顺行灌注60 m l/kg时自左心耳抽取灌洗液。然后在左心耳插管做逆行灌注,在灌注10 m l/kg和20 m l/kg时分别自主肺动脉抽取灌洗液。再次于主肺动脉插管,在顺灌80 m l/kg和100 m l/kg时分别自左心耳抽取灌洗液。将所取灌洗液在40倍显微镜下做红细胞计数。结果5组灌洗液红细胞计数分别为164.0±12.3、172.0±23.9、79.0±4.8、53.0±3.4和34.0±4.2,其中顺灌60 m l/kg和逆灌20 m l/kg组、顺灌60 m l/kg和顺灌80 m l/kg组、顺灌80 m l/kg和顺灌100 m l/kg组的差异有统计学意义。结论灌注液的量与灌洗液红细胞计数呈负相关趋势,逆灌可以弥补顺灌在末梢血管冲洗上的不足,同时这个指标尚可进一步应用于肝、肾、心脏等其它器官移植中。

Objective To study the relativity of the amount of lavage fluid and the number of red blood cell in lavage fluid. Methods Ten Wuzhishan pigs were used for this experiment. Lavage fluid was obtained after different perfusion methods： after antegrade cold flush perfusion （ LPD solution） with 60ml/Kg through pulmonary artery, lavage fluid was obtained through left atrium; after retrograde cold flush perfusion with 10 ml/kg and 20ml/Kg through left atrium, lavage fluid was obtained through pulmonary artery, after antegrade cold flush perfusion with 80ml/Kg and 100ml/Kg through pulmonary artery, lavage fluid was obtained through left atrium. The number of red blood ceils in lavage fluid was counted. Results The number of red blood ceils in lavage fluid in above five groups were 164 ± 12.3, 172 ± 23.9, 79 ± 4.8, 53 ± 3.4 and 34 ±4.2 respectively. There were significant differences in the number of red blood ceils between the groups of antegrade 60ml/kg perfusion and retrograde 20 ml/kg perfusion, antegrade 60ml/Kg perfusion and 80ml/kg perfusion, and antegrade 80 ml/kg perfusion and 100 ml/kg perfusion. Condusion Negative correlation was found between the amount of lavage fluid and the number of red blood ceils in lavage fluid. Retrograde flush perfusion lead to better graft function than the standard antegrade perfusion. Accounting of red blood cells can be used in the field of other organ transplantation.