静脉-动脉方向持续超滤对婴幼儿体外循环手术肺保护的研究

The Clinical Application of V-A Continuous Ultrafiltration during Extracorporeal Circulation in Infants.

目的研究在婴幼儿体外循环心内直视手术中应用静脉-动脉方向持续超滤对排除炎症介质，浓缩血液，防止和减轻体外循环后怖损伤的效果。方法将50例先天性心脏病患儿随机分成对照组和实验组，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朋静脉-动脉方向持续超滤，观察患儿血浆中炎症介质浓度、红细胞压积（HCT）、白蛋白浓度和肺功能指标。结果实验组体外循环后白介素IL-6、TNF血浆浓度明显低于对照组，红细胞压积（HCT）和血白蛋白浓度明显高于对照组，实验组肺功能损害减轻。结论体外循环中采用静脉-动脉方向持续超滤，可有效地排除部分炎症介质，浓缩血液，缩短手术时间，减轻肺水肿和肺损伤。

Objective To evaluate the efficacy of V-A Continuous uhrafiltration technique in excluding harmful inflammatory mediators, concentrating blood, preventing and relieving the extraeorporeal circulation （ECC） related pulmonary injury in infants. Methods Fifty patients with congenital heart defects were divided into two groups. The conventional ECC was used in all infants, while the V-A Continuous uhrafiftration was used additionally in the treated group. The inflammatory mediators, hematocrit, serum albumin concentrations and the pulmonary function parameters were measured. Results The inflammatory mediators were decreased, hematocrit and serum albumin concentrations were increased ,the puhnonary function was improved in the treated group compared with the control group. Conclusions V-A Continuous ultrafihration can effectively exclude some harmful inflammatory mediators, concentrate blood, attenuate the lung edema and injury.