改良超滤在成人瓣膜置换术中的应用研究

Application of modified ultrafiltration in adult valve replacement

目的探讨改良超滤技术（MUF）应用于成人瓣膜置换术中的作用和意义。方法200例成人心脏瓣膜病患者随机分为实验组（MUF组）和对照组（CUF组），每组100例。实验组术中采用常规超滤联合改良超滤，对照组采用常规超滤。对两组患者术中及术后早期临床资料进行比较研究。结果两组红细胞压积（HCT）术前比较差异未见统计学意义（P〉0.05），改良超滤后实验组HCT显著高于对照组（P〈0.05）；实验组围术期库血用量和术后24 h引流量显著小于对照组（P〈0.05）；实验组术后呼吸机辅助时间和ICU停留时间显著短于对照组（P〈0.05）。结论改良超滤可在停机后短时间内浓缩血液，提高患者红细胞压积，改善凝血功能，减少出血和库血使用量；减轻脏器水肿，改善脏器功能，促进患者早期恢复。MUF应用于成人心脏瓣膜置换术中效果显著，且不增加任何费用，值得临床推广应用。

Objective To investigate the effect of modified ultrafiltration technology （MUF） on adult valve replacement.MethodsTwo hundreds patients with adult heart valvular disease were randomly divided into experimental group （MUF group） and control group （CUF group）, with 100 cases in each group. The experimental group was given conventional ultrafiltration and modified ultrafiltration, while the control group only received conventional ultrafiltration. Then the preoperative and perioperative clinical data of the two groups were compared.ResultsBefore operation, there was no significant difference in hematocrit between the two groups. However, the experimental group showed higher level of hematocrit than the control group after modified ultrafiltration （P〈0.05）. In addition, both dosage of banked blood during operation and quantity of drain 24 hours after surgery in the experimental group were significantly less than those in the control group （P〈0.05）. Compared with control group, the experimental group showed shorter postoperative ventilator assisted time and shorter stay in ICU （P〈0.05）.ConclusionsModified ultrafiltration can concentrate blood in the short term, enhance hematocrit, improve coagulation function, reduce bleeding, decrease the dosage of banked blood, relieve organ edema, promote organ function and accelerate early recovery of patients. MUF can be applied to adult valve replacement with higher efficacy and no any additional costs, which should be widely popularized.