微温体外循环对von Willebrand因子及血栓调节蛋白的影响

Effect of tepid temperature cardiopulmonary bypass on von Willbrand factor and thrombomodulin

目的 :观察微温体外循环对心内直视手术患者围术期 von Willebrand因子 (v WF)和血栓调节蛋白 (TM)的影响。方法 :3 6例风心病瓣膜置换患者随机分为实验组 (鼻咽温 3 2～ 3 4℃ )和对照组 (鼻咽温 2 7～ 3 0℃ ) ,动态监测围术期血浆 v WF及 TM水平变化 ,并记录输血量及术后引流量。结果 :实验组血浆 v WF及 TM水平在术中及术后2 4h均低于对照组 (P<0 .0 5 ,P<0 .0 1) ,且输血量及术后引流量也明显低于对照组 (P<0 .0 1)。结论 :微温可减轻体外循环对血管内皮细胞的激活或损伤 。

AIM:To observe the effect of tepid temperature cardiopulmonary bypass(CPB) on the plasmatic von willibrand factor (vWF) and thrombomodulin (TM). METHODS:Thirty six cases were randomly divided into Group A (nasopharygeal temperature 32~34℃) and Group C(control group, nasopharygeal temperature 27~30℃). Changes in the parameters of plasmatic vWF and TM were measured at various time points during the whole period. RESULTS:The plasmatic vWF and TM in Group A were significantly less than those in Group C during and 24 h after the operation( P <0.05 or P <0.01). Besides, allogeneic blood transfusions and the postoperation 24 h chest tube drainage were significantly less than those in Group C( P <0.01). CONCLUSION:The tepid temperature CPB reduced postoperative blood loss and preserved endothelial cells.