持续超滤在婴幼儿体外循环手术中的临床应用

Continuous ultrafiltration during cardiopulmonary bypass in infants

目的探讨持续超滤在婴幼儿体外循环心内直视手术中的应用价值。方法将50例先天性心脏病患儿随机分为对照组和实验组。对照组作常规体外循环,不应用超滤;实验组在体外循环中应用持续超滤,观察患儿血浆中白细胞介素-6(IL-6)、肿瘤坏死因子(TNF)血浆浓度、红细胞压积(HCT)、白蛋白浓度、肺功能及术后恢复时间等指标。结果与对照组比较,实验组体外循环后IL-6、TNF血浆浓度明显降低,HCT和血白蛋白浓度明显升高,肺功能损害减轻,术后恢复时间缩短(P均<0.05)。结论体外循环采用持续超滤,可有效排除部分炎症介质,浓缩血液,减轻肺水肿和肺损伤,促进术后恢复。

Objective To investigate the clinical effect of continuous ultrafiltration in open heart surgery with cardiopulmonary bypass （CPB） for infants. Methods Fifty patients with congenital heart defects were randomly divided into two groups. In the control group, conventional CPB was used without ultra_filtration. In the treatment group, in addition to the same CPB, continuous ultrafiltration was used throughout CPB. Serum concentrations of interleukin-6（IL-6） and tumor necrosis factor（TNF）, hematocrit （HCT）, serum albumin concentrations, pulmonary function and the recovery time after the operations were measured. Results Serum concentrations of IL-6 and TNF were significantly decreased, HCT and serum albumin concentrations were significantly increased, pulmonary function was improved and the recovery time after the operations was shortened in the treatment group com- pared with the control group （ P 〈 0. 05）. Conclusion Continuous ultrafiltration can effectively exclude some harmful inflammatory mediators, concentrates the blood, attenuates lung edema and injuries, and promotes recovery after operations.