零平衡超滤对降钙素原及呼吸功能的影响

Effect of Zero-Balanced Ultrafiltration on Procalcitonin and Respiratory Function after Extracorporeal Circulation

目的研究体外循环中零平衡超滤对法洛四联症手术患儿术后降钙素原（procalciton in,PCT）血浆浓度及呼吸功能的影响。方法选择20例法洛四联症手术患儿,随机分为两组。试验组（n=10）于体外循环复温后行零平衡超滤及常规超滤,对照组（n=10）于复温后仅施行常规超滤。术前、超滤前、术后即刻、术后12 h、24 h、48h监测PCT浓度及呼吸功能。结果术后12 h PCT开始升高,24 h达到顶峰,48 h未恢复到术前水平。术后12~48 h试验组PCT水平低于对照组,但差异无统计学意义（P〉0.05）。术后12 h试验组肺顺应性高于对照组（P〈0.05）,术后即刻和12 h氧指数有增高的趋势。试验组机械通气时间缩短（P〈0.01）,PCT峰浓度与机械通气时间正相关（P〈0.01）。结论零平衡超滤对降低术后PCT血浆浓度可能有效,可以改善术后通气功能、缩短术后机械通气时间,有改善氧合功能的趋势。术后呼吸功能改善可能与PCT浓度降低有关。

OBJECTIVE To determine the effect of zero - balanced ultrafihration （ZBUF） on procalcitonin （PCT） and respiratory function of infants with tetralogy of Fallot（TOF） after extracorporeal cireulation（ECC）. METHODS 20 infants with TOF undergoing open -heart surgical correction were assigned randomly to two groups. Trial group was given 50 ml/kg ZBUF and conventional ultrafiltration（ CUF）, while control group was given only CUF. Peri - operative plasma PCT and pulmonary function were monitored and compared. RESULTS PCT were decreased in trial group between 12 h and 48 h postoperatively but not reaching statistical significance. Trial group＇s pulmonary compliance was higher 12 h postoperatively（ P 〈 0.05 ）. Oxygenation index were increased in trial group 0 and 12 h postoperatively（ P 〉 0.05 ）. Intubation time was shorter in trail group（ P 〈0.01 ）. Positive correlation was found between PCT peak concentration and intubation time. CONCLUSION ZBUF is likely to decrease plasma PCT. ZBUF could improve ventilation and oxygenation,and shorten intubation time. Improved respiratory function may due to the lower plasma PCT.