二氧化碳血液净化仪实验研究

The Experimental Study on Carbon Dioxide Blood Purification Meter

目的探讨气体传输型二氧化碳血液净化仪在呼吸衰竭(RF)治疗中实施体外膜肺氧合(ECMO)部分循环支持的实验研究。方法建立实验犬的RF模型,用BaxterEF-550血管路连接二氧化碳血液净化仪,股静脉置入双腔单针导管行V-V转流,转流过程中维持血流量200mL/min,氧入通入量4L/min^6L/min,转流开始10min后,分别采集动脉血及膜式人工肺出入端血标本,以后每转流60min分别采集血标本进行血气分析。结果人工肺出入端PCO2可由50.93mmHg±1.62mmHg^63.27mmHg±0.46mmHg下降为1.27mmHg±0.05mmHg^14.07mmHg±1.86mmHg,PO2上升值为371.6mmHg±42.67mmHg^614.6mmHg±50.35mmHg,人工肺出入端PCO2、TCO2、PO2、SO2、O2-C变化均有显著性差异(P<0.01)。转流60min,实验犬体动脉血PaO2从39.6mmHg,升高为56.7mmHg±2.36mmHg,PCO2由52.8mmHg下降为50.4mmHg±0.53mmHg。结论二氧化碳血液净化仪有良好的二氧化碳血液净化和氧传输双重性能;二氧化碳血液净化仪的气体传输性能,在0.2L/min流量时,可以使活体实验动物血气发生改变———氧摄入和二氧化碳排出增多,从而简化了ECMO技术并实现呼吸支持的作用,为呼吸衰竭的救治提供一项新的技术和途径。

Objective To discuss the supporting-circulation action of gas transfusion type carbon dioxide blood purification meter in the treatment of RF when the patients are treated with extracorporeal membrane oxygenation （ ECMO）. Materials and Methods The experimental dog RF model was established. Femoral vein V-V shunt assay was connected with the carbon dioxide blood purification meter by BaxterEF-550 blood vessel. In the shunt assay, blood flow was maintained at 200mL/min, and the entry volume of oxygen was 4L/rain-6L/rain. After 10 minutes, the blood samples of artery and membrane artificial lung were collected every 60 minutes and blood gas volume was analysed. Results The entry PCO2 of membrane artificial lung dropped to 1.27mmHg± 0.05mmHg～14.07mmHg±1.86mmHg from 50.93mmHg±1.62mmHg - 63.27mmHg± 0.46mmHg, and the rising value of PO2 was 371.6mmHg± 42.67mmHg～614.6mmHg±50.35mmHg. It had a significant difference in PCO2, TCO2, PO2, SO2, O2-C change, P 〈 0.01. After 60 minutes, PaO2 rised from 39.6mmHg to 56.7mmHg± 2.36mmHg and PCO2 dropped from 52.8mmHg to 50.4mmHg ± 0.53mmHg. Conclusion The carbon dioxide blood purification meter had functions of both carbon dioxide blood purification and oxygen transfusion. The inhaling volume of O2 and discharging volume of CO2 of the experimental dog were increased when the flow was in 0. 2L/rain. It provided a new way for the treatment of RF.