体外循环中联合超滤方法对低龄低体质量婴幼儿心脏手术后肺功能的影响

Effects of extracorporeal circulation combined with ultrafiltration on lung function after heart surgery in infants and young children with low body mass

目的探讨体外循环中联合超滤方法对低龄低体质量婴幼儿心脏手术后肺功能的影响。方法选择2015-04~2016-03我院收治的需行心脏手术的低龄低体质量婴幼儿50例,根据治疗方式不同分为两组,各25例。对照组实施常规超滤,观察组实施常规超滤+零平衡超滤+改良超滤。比较两组肺功能及血浆蛋白、红细胞比容(HCT)水平。结果术后观察组肺泡-动脉氧分压差[(A-a)DO2]低于对照组,肺静态顺应性、氧合指数高于对照组,差异有统计学意义(P<0.05);观察组血浆蛋白、HCT水平高于对照组,差异有统计学意义(P<0.05)。结论 CPB中联合超滤方法能有效减轻低龄低体质量婴幼儿心脏手术后肺损伤,改善肺功能,值得临床推广。

Objective To explore the effects of extracorporeal circulation combined with ultrafiltration on lung function after heart surgery in infants and young children with low body mass. Methods 50 infants and young children with low body mass were collected in our hospital from April 2015 to March 2016. Before cardiac surgery, the patients were divided into two groups according to the different treatment methods, with 25 cases in each group. The control group received routine ultrafiltration and the observation group was given routine ultrafiltration＋zero-equilibrium ultrafiltration＋modified ultrafiltration. The lung function and the levels of plasma protein and erythrocyte ratio（HCT） were compared between the two groups. Results After the surgery, the alveolar arterial oxygen differential pressure [（A-a）DO2] was significantly lower and the pulmonary static compliance and oxygenation index were significantly higher in the observation group than those in the control group （P〈0.05）. The levels of plasma protein and HCT in the observation group were significantly higher than those in the control group（P〈0.05）. Conclusion Extracorporeal circulation combined with ultrafiltration can effectively reduce the lung injury after heart surgery and improve their lung function in the infants and young children with low-body mass.