摘要
目的评价左心吸引压力监控技术用于心脏手术体外循环的效果。方法择期在体外循环下行心脏瓣膜置换术的患者80例,性别不限,年龄40~64岁,体重50~80 kg,ASA分级Ⅱ~Ⅳ级,NYHA心功能分级Ⅱ或Ⅲ级,LVEF≥40%,采用随机数字表法分为2组(n=40):传统左心吸引组(T组)和左心吸引压力监控技术组(M组)。T组根据左心吸引量和术野清晰程度,调整左心吸引泵的转速;M组通过对左心吸引管内压力的实时监测,调整左心吸引泵的转速。吸闭恢复正常吸引后取左心回血,测定游离血红蛋白浓度。记录左心吸闭后调整次数、术中血红蛋白尿和术后吸引管沉淀物的发生情况。结果与T组比较,M组游离血红蛋白浓度、术中血红蛋白尿发生率和术后吸引管沉淀物发生率降低,左心吸闭后调整次数减少(P<0.05)。结论左心吸引压力监控技术可安全有效地用于心脏手术体外循环。
Objective To evaluate the efficacy of left heart attracting pressure monitoring technology applied in cardiopulmonary bypass(CPB)in cardiac surgery.Methods Eighty patients of both sexes,aged 40-64 yr,weighing 50-80 kg,of American Society of Anesthesiologists physical statusⅡ-Ⅳ,with New York Heart Association gradeⅡorⅢ,with left ventricular ejection fraction≥40%,undergoing elective cardiac valve replacement,were divided into 2 groups using a random number table method:traditional left heart aspiration group(T group)and modified left heart aspiration group(M group),with 40 patients in each group.The rotation speed of left ventricular suction pump was adjusted according to left ventricular suction volume and surgical field clarity in group T and by monitoring the pressure in the left suction tube in real time in group M.After aspiration returned to normal aspiration,blood of the left heart returned after aspiration was collected to determine the concentration of free hemoglobin.The number of adjustments after left ventricular aspiration,intraoperative hemoglobinuria,and occurrence of tissue sediment in the aspiration tube after operation were recorded.Results Compared with T group,the concentration of free hemoglobin,incidence of intraoperative hemoglobinuria and incidence of tissue sediment in the aspiration tube after operation were significantly decreased,and the number of adjustments after left ventricular aspiration was decreased in M group(P<0.05).Conclusion Left heart attracting pressure monitoring technology can be safely and effectively applied in CPB in cardiac surgery.
作者
钱晓亮
陈月
赵惠
丁卫卫
张伟
Qian Xiaoliang;Chen Yue;Zhao Hui;Ding Weiwei;Zhang Wei(Department of Extracorporeal Circulation,Henan Provincial People′s Hospital Zhengzhou University People′s Hospital Fuwai Central China Cardiovascular Hospital,Zhengzhou 450000,China;Department of Anesthesiology and Perioperative Medicine,Henan Provincial People′s Hospital Zhengzhou University People′s Hospital,Zhengzhou 450000,China;Department of Cardiovascular Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2021年第8期988-991,共4页
Chinese Journal of Anesthesiology
基金
河南省医学科技攻关计划省部共建项目(20190796)。
关键词
体外循环
心脏外科手术
左心吸引压力监控技术
Extracorporeal circulation
Cardiac surgical procedures
Left heart attracting pressure monitoring technology
