体外循环心脏手术对微循环和红细胞形态、功能的影响

Impact of Cardiac Surgery with Cardiopulmonary Bypass on Microcirculation, Red Blood Cell Morphology and Function

探讨和研究红细胞损伤与微循环障碍的关系，为临床血液保护提供有效的防治措施。对２０例体外循环心脏手术患者围术期的红细胞变形性、红细胞聚集性、游离血红蛋白、红细胞超微结构和甲皱微循环进行动态观察。发现红细胞变形性下降，聚集性增加以及异常红细胞的出现，是体外循环心脏手术毛细血管阻塞、微循环障碍的主要原因。红细胞损伤与体外循环时间、红细胞聚集性呈正相关，与红细胞变形性呈负相关。防治红细胞损伤和破坏是降低术后并发症和死亡率的重要措施和手段。

For the purpose of studying and exploring the relationship between red blood cell trauma and impaired microcirculation, 20 patients underwent openheart surgery were studied. The red blood cell deformability, red blood cell aggregability, plasma hemoglobin, red blood cell ultrastructure and nailbed microcirculation were monitored and observed perioperatively. We found that reduced red cell deformability, increased red cell aggregability and abnormal red blood cell were the main reasons for impaired microcirculaton. The correlation between red blood cell trauma and cardiopulmonary bypass time as well as red cell aggregability was positive, and the correlation between red blood cell trauma and red cell deformability was negative. Therefore, it is essential to prevent red blood cell trauma during openheart surgery.