自体肺氧合减少体外循环术后炎症性肺损伤的实验研究

Effect of autogenous lung as oxygenator in cardiopulmonary bypass on lung protection at cardiac surgery

目的探讨体外循环术中采用自体肺代替人工氧合器对肺功能的保护作用。方法 10只实验小猪随机分为实验组和对照组。实验组体外循环术中采用自体肺代替人工的氧合器进行氧和;对照组采用常规人工氧合器体外循环的方法。分别体外循环转流120min,主动脉阻断60min。测定实验前后血浆IL-6、IL-8、TNF-α。结果两组体外循环后血浆中IL-6、IL-8、TNF-α均较术前升高,对照组不同时间点各炎性因子水平均高于实验组(P<0.05)。结论自体肺能够耐受体外循环术中的非搏动性血流,且可显著减轻体外循环术中因采用人工氧合器而引起的炎性反应性肺损伤,减少对肺组织的损伤。

Objective To investigate the protection for lung function by autogenous oxgenator in cardiopulmonary bypass operation. Methods Ten piglets were randomly divided into two groups with five each. The experimental group underwent biventricular bypass with autologous lung perfusion, while control group underwent conventional cardiopulmonary bypass with artificial oxygenator. The bypass time and aortic cross clamping time were 120 min and 60 min respectively for each animal. The lung static compliance （Cstat）, TNF-a, IL-6, and IL-8 were measured. Histological and ultrastructure changes of the lung were also observed after bypass. Results After cardiopulmonary bypass, the content of TNF-a, IL-6, and IL-8 increased for both groups, and the changes of experimental group were much less than those of control group （P〈0.05）. Milder pathophysiological changes in experimental group were also demonstrated. Conclusion Autologous lung can tolerate nonpulsatile perfusion. It can be used as oxygenator in cardiopulmonary bypass operation. The autogenous oxygenator cardiopulmonary bypass technique can provide satisfactory oxygenation and even better lung function.