中国体外循环杂志2017，Vol.15Issue(3)：144-147,4.DOI:10.13498/j.cnki.chin.j.ecc.2017.03.05
改良超滤与零平衡超滤对高风险心脏瓣膜置换术患者术后心肺功能的影响
Comparison of modified and zero-balance ultrafiltration on postoperative cardiac and pulmonary function of high risk patients underwent heart valve replacement operation
摘要
Abstract
Objective To determine the protective effects of modified ultrafiltration and zero-balanced ultrafiltration on postoperative cardiac and pulmonary function of high risk patients underwent heart valve replacement operation.Methods Ninety high risk patients with heart valve diseases were randomly divided into 2 groups: modified ultrafiltration group (MUF group) and zero-balanced ultrafiltration group (ZUF group).The following indicators were compared between 2 groups,including aortic aortic clamping time,ultrafiltration time and total volume,transfusion volume during operation,the oxygen partial pressure (PO2),carbon dioxide partial pressure (PCO2),hematocrit (Hct),tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) concentration before cardiopulmonary bypass (CPB),after CPB and after ultrafiltration,the duration of postoperative mechanical ventilation and ICU stay,left ventricular ejection fraction one week after the surgery,dopamine dosage and duration,myocardial enzymes and troponin I,troponin T changes at postoperative 24 h.Results All patients were successfully completed surgery.Compared with ZUF group,time and total volume of ultrafiltration as well as red blood cell transfusion volume during operation were lower in MUF group (P<0.05);PO2 and Hct in MUF group were significantly higher than those in ZUF group after ultrafiltration,there was no difference between two groups at PCO2.TNF-α and IL-6 of ZUF group were lower than MUF group after CPB and after ultrafiltration (P<0.05);the duration of mechanical ventilation,dosage and duration of dopamine uesd after operation in MUF group were shorter than ZUF group (P<0.05).Conclusion Although ZUF could reduce the levels of inflammatory factors,MUF is more suitable for high risk patients underwent heart valve replacement operation,MUF can significantly increase the postoperative PO2 and Hct level,reduce intraoperative blood transfusion,shorten the duration of mechanical ventilation,dosage and duration of dopamine after operation.关键词
改良超滤/高风险/心脏瓣膜置换Key words
Modified ultrafiltration/High risk/Heart valve replacement引用本文复制引用
俞瑾,詹海婷,李帆,苟伟挺,王江,郑宏..改良超滤与零平衡超滤对高风险心脏瓣膜置换术患者术后心肺功能的影响[J].中国体外循环杂志,2017,15(3):144-147,4.基金项目
新疆维吾尔族自治区科技支撑计划项目(201533102) （201533102）
