摘要
目的:探讨符合超滤对婴幼儿体外循环术后肺功能的影响。方法:选取我院2008年8月至2012年2月收治的300例复杂重症先天性心脏病患儿为研究对象,按照随机原则分为对照组、改良超滤组和复合超滤组,其中对照组在整个体外循环术过程中不使用超滤,改良超滤组在体外循环结束后采用改良超滤,复合超滤组在体外循环过程中应用平衡超滤,体外循环结束后开始运用改良超滤,比较三组患儿在转流前(T1)、转流结束后20min(T2)、术后2h(T3)、术后6h(T4)、术后12h(T5)及术后24h(T6)时的潮气量(TV)、呼吸停顿压(Ppause)、气道峰压值(Ppeak)、呼吸频率(F)、吸入氧浓度(FiO2)等肺功能指标的变化。并在测定以上6个时间点的白细胞介素6(IL-6)、肿瘤坏死因子(TNF-α)的含量。结果:三组患者术后的肺静态顺应性(Cstat)、氧合指数(OI)显著低于术前,肺泡一动脉氧分压(AaDO2)显著高于术前,P<0.05。复合超滤组在T4、T5的Cstat、OI显著高于对照组和改良超滤组,P<0.05,改良超滤组的要显著高于对照组,P<0.05。复合超滤组在T4、T5的AaD02显著低于对照组和改良超滤组,P<0.05,改良超滤组的要显著高于对照组,P<0.05。三组患儿术后的IL-6、TNF-α显著高于术前,P<0.05。复合超滤组在T2、T3、T4、T5的IL-6、TNF-α显著低于对照组和改良超滤组,P<0.05。结论:复合超滤能够改善患儿肺的通气功能和换气功能,有效减轻全身炎症反应,使患儿能在术后尽早脱机,减少CPB术后并发症,保护患儿肺功能。
Objective：To study accord with ultrafiltration in infants and young children extracorporeal circulation after the influence of lung function.Methods：Select from August 2008 to February 300 cases were complicated severe congenital heart disease children as the research object,according to the principle of random divided into control group,improved ultrafiltration group and composite ultrafiltration group,the control group in the whole extracorporeal circulation technique process without the use of ultrafiltration,improved ultrafiltration group in extracorporeal circulation after modified ultrafiltration,composite ultrafiltration group in extracorporeal circulation in the process of using balance ultrafiltration,extracorporeal circulation after modified ultrafiltration,compare three groups in turn flow children before（T1）,turn flow after 20 min（T2）,postoperative 2 h（T3）,postoperative 6 h（T4）,postoperative 12 h（T5） and postoperative 24 h（T6） when the tide volume（TV）,respiratory pause pressure（Ppause）,airway peak voltage value （Ppeak）,respiratory frequency（F）,suction oxygen concentration（FiO2） and so on pulmonary function indexes to change.In the determination and above six time point of interleukin 6（IL-6）,tumor necrosis factor（TNF alpha） content.Results：Three groups of patients postoperative lung static compliance（Cstat）,oxygenation index（OI） were significantly lower than,the alveolar a arterial oxygen partial pressure（AaDO2） were significantly higher,P0.05.Composite ultrafiltration group in T4,T5 of Cstat,OI significantly higher than those in the control group and improved ultrafiltration group,P0.05,improved ultrafiltration group to a significantly higher than those in the control group,P0.05.Composite ultrafiltration group in T4,T5 of AaD02 significantly lower than those of the control group and improved ultrafiltration group,P0.05,improved ultrafiltration group to a significantly higher than those in the control group,P0.05.Three groups of po
出处
《中国医药导刊》
2012年第12期2028-2029,2027,共3页
Chinese Journal of Medicinal Guide
关键词
复合超滤
婴幼儿
体外循环术
先心病
肺功能
Composite ultrafiltration
Baby
Extracorporeal circulation technique
Congenital heart disease
Lung function
