心内吸引减压阀的研制与临床应用

Development and Application of Cardiotomy Suction Relief Valve

目的为了减轻体外循环心内吸引力过大,所产生的负压对红细胞和心内膜的破坏,将研制的一种心内吸引减压阀我们在临床试用。方法60例室间隔缺损患儿随机分为减压组和对照组,每组30例,减压组体外循环中心内吸引应用减压阀,对照组体外循环中心内吸引不用减压阀。转流中用负压表进行心内吸引管负压测定。分别在转流10 min和1 h采血2 ml,测定血浆游离血红蛋白(FHb)浓度、红细胞比积(Hct)、血红蛋白(Hb)、红细胞计数(RBC)。术中取右心房心内膜活检做病理观察。结果转流1 h对照组FHb较减压组显著增高,有统计学意义(P<0.05)。两组间转流10 min、1 h的Hct、Hb、RBC差异均无统计学意义(P>0.05)。对照组发现心内膜病理改变,减压组未见心内膜的损伤。结论心内吸引减压阀可减小体外循环心内吸引管内的负压,减轻红细胞破坏和心内膜伤害,有保护心内膜以及红细胞的作用。

OBJECTIVE In order to reduce the damage of negative pressure from cardiotomy suction on red blood cell and endocardium during extracorporeal circulation （ECC）, we developed a cardiotomy suction relief valve and applied clinically. METHODS Sixty children suffering from ventricular septal defect were randomly divided into decompression group and control group, and each group included thirty cases. Cardiotomy suction relief valve was applied in decompression group and not in control group during ECC. Cardiotomy suction negtive pressure was deteimined by vacuo meter during ECC. Free hemoglobin concentration in plasma, hematocrit, hemoglobin and red blood cell count were determined at ten minute and one hour after bypass. Pathology of right atrium endocardium was also observed. RESULTS Free hemoglobin concentration in plasma was significantly higher in control group than that in decompression group at one hour after bypass. There was no significant difference in hematocrit, hemoglobin and red blood cell count between two groups at both ten minute and one hour after bypass. In addition, endocardium damage was found in control group, and was not found in decompression group during bypass. CONCLUSION Application of cardiotomy suction relief valve reduces the negative pressure of cardiotomy suction, consequently prevents endocardium and red blood cell from hematoclasis and endocardium damage.