改良超滤对成人心脏瓣膜替换术后左心功能的影响

Modified ultrafiltration improves left ventricular function after replacement of adults' heart valves

目的 :探讨改良超滤对成人心脏瓣膜替换术后左心功能的影响。 方法 :2 2例成人心脏瓣膜替换术患者随机分为改良超滤 (MUF)组 (n =10 )和无超滤对照组 (n =12 ) ,动态观察体外循环 (CPB)前、CPB停时及MUF结束时 (对照组CPB停后15min) 3个时间点心排量 (CO)、心排指数 (CI)、每搏输出量 (SV)、每搏指数 (SVI)、平均动脉压 (MAP)、左室每搏做功指数(IVSWI)等心功能指标。 结果 :MUF组超滤后CO、CI、SV、SVI、LVSWI均较CPB停时明显升高 (P <0 .0 5 ) ;对照组停CPB时与CPB停后 15min相比 ,各项指标无显著性差异。MUF组超滤后与对照组CPB停后 15min相比 ,CI和LVSWI升高显著(P <0 .0 5 )。 结论 :在成人心脏瓣膜替换术中 ,应用改良超滤技术可以减轻心肌水肿 ,提高心脏指数 。

Objective:To test the hypothesis that use of modified ultrafiltration (MUF) after cardiopulmonary bypass can improve blood dynamics in adults' valve replacement.Methods:Twenty two adult patients undergoing valves replacement were randomized into MUF group( n =10) and control group( n =12).Their CO,CI,SV,SVI,LVSWI,and MAP at pre CPB,end CPB,and post MUF (or 15 min post CPB in control group) were measured.Results:In the MUF group,CO,CI,SV,SVI,MAP,LVSWI at post MUF increased significantly compared with those end CPB( P <0.05); In MUF group CI and LVSWI were significantly higher at post MUF point than those in control group at 15 min post CPB ( P <0.05).Conclusion:MUF in adults' valve replacement can improve left ventricular systolic function and diastolic compliances,improve cardiac index and cardiac function.