中国组织工程研究与临床康复2011，Vol.15Issue(5)：835-838,4.DOI:10.3969/j.issn.1673-8225.2011.05.018
浅低温体外循环心脏不停跳瓣膜置换的肺保护
Lung protection of mitral valve replacement operation on beating-heart with mild hypothermic cardiopulmonary bypass
谢晓勇 1何巍 1冼磊 1郑宝石 1冯旭 1周涛 1高建朝1
作者信息
- 1. 广西医科大学第一附属医院心胸外科,广西壮族自治区南宁市,530021
- 折叠
摘要
Abstract
BACKGROUND: The treatment of beating-heart with mild hypothermic cardiopulmonary bypass (CPB) may lessen lung injury after intracardiac operation underdirects vision, but mechanism of action remains unclear.OBJECTIVE: To evaluate the lung protection of mitral valve replacement operation on beating-heart with mild hypothermic CPB.METHODS: A total of 40 patients underwent mitral valve replacements which were randomly divided into experimental group and control group. Patients in the experimental group were performed operation on beating-heart with mild hypothermic CPB, while patients in the control group received operation on arrested heart with moderate hypothermia CPB. Bronchoalveolar lavage fluid (BALF) was collected at 30 minutes (two time points) replacement started and after CPB. The levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and myeloperoxidase (MPO) in BALF were measured. Neutrophil was measured by left and right atrial blood respectively before CPB and 30 minutes after CPB, and then the transpulmonary polymorphonuclear was calculated.Respiratory index (RI) was calculated before CPB, at the end of CPB, 1 hour and 8 hours after CPB.RESULTS AND CONCLUSION: The levels of TNF-α, IL-8, MPO in BALF and transpulmonary polymorphonuclear in blood at 30 minutes after CPB were significantly increased in experimental group and control group (P ＜ 0.01). But levels of those in the experimental group were lower significantly than that in the control group (P ＜ 0.05). The levels of RI at the end of CPB, 1 hour and 8 hours after CPB were significantly increased in two groups (P ＜ 0.05), but the level in the experimental group was lower significantly than that in the control group (P ＜ 0.05). It is indicated that mitral valve replacement operating on beating-heart with mild hypothermic CPB can lighten lung injury and has a better effect on lung protection.关键词
浅低温体外循环心脏不停跳/二尖瓣置换/肺保护/急性肺损伤/体外循环分类
基础医学引用本文复制引用
谢晓勇,何巍,冼磊,郑宝石,冯旭,周涛,高建朝..浅低温体外循环心脏不停跳瓣膜置换的肺保护[J].中国组织工程研究与临床康复,2011,15(5):835-838,4.
