平衡超滤联合改良超滤技术减轻体外循环肺损伤的研究

Balanced ultrafiltration combination with modified ultrafiltration technique attenuates pulmonary injury during cardiopul monary bypass

目的探讨平衡超滤联合改良超滤技术的应用对防止和减轻体外循环后肺损伤的作用。方法将40例先天性心脏病患儿分成对照组和实验组,对照组采取常规体外循环,实验组在体外循环中联合采用常规超滤和改良超滤,观察患儿肺功能情况、血液浓缩指标及血浆炎症介质浓度。结果实验组体外循环后肺通气和肺换气功能均获改善,红细胞压积(HCT)和血浆白蛋白浓度均明显高于对照组,血浆白介素6(IL-6)和血栓素B2(TXB2)浓度明显低于对照组。结论体外循环联合平衡超滤和改良超滤,能有效浓缩血液,降低血浆炎症介质浓度,减轻炎症反应性肺损伤。

Objective To study balanced uhrafiltration combination with modified uhrafihration technique to prevent and ameliorate the pulmonary injury during eardiopulmonary bypass. Methods 40 eases with congenital heart defects were divided into control group and treated group. In the control group, the conventional cardiopulmonary bypass was used without ultrafiltration, while in the treated group additional ultrafihration was sued from the beginning to the end of CPB, The pulmonary function parameters, hematocrit （HCT）, serum albumin and concentrations of inflammatory mediators were measured. Results Comparing with the control group, the pulmonary function was improved,with increase of HCT and serum albumin concentrations and decrease of some inflammatory mediators, concentration in the treatment group. Conclusions Combined conventional and modified ultrafiltration can effectively increase the blood concentration, eliminate some harmful inflammatory mediators, and attenuate pulmonary injury due to inflammatory response.