中国体外循环杂志2019，Vol.17Issue(1)：36-40,5.DOI:10.13498/j.cnki.chin.j.ecc.2019.01.09
体外循环中动脉路白细胞滤除对心脏手术后患者肺功能影响的随机对照研究
Effects of leukocyte depletion from the arterial line during cardiopulmonary bypass on postoperative pulmonary function
摘要
Abstract
Objective To evaluate the effects of leukocyte depletion in the arterial line during cardiopulmonary bypass on postoperative pulmonary function in patients after cardiac surgery. Methods Forty patients aged 22-65 yr, with American Society of Anesthesiologists Physical Status Ⅱ or Ⅲ, scheduled for elective cardiac valve replacement surgery with CPB, were divided into two groups (n = 20 each) by using a random number table. In experimental group (group LD), blood was filtered with a leukocyte depleting filter placed in the arterial line of the CPB circuit since the start of rewarming until the termination of CPB. Blood samples were taken before CPB (T1), ten minutes after aortic unclamping (T2), at the end of CPB (T3), 12 and 24 h after T3 (T4-5) to examine blood components and serum levels of TNF-α, IL-6, MDA and SOD. Meanwhile respiratory ventilation parameters and blood gas analyses were also recorded to calculate the static pulmonary compliance (Cstat), oxygenation index (OI) and respiratory index (RI). The mechanical ventilation time, ICU stay time, incidence of oxygen desaturation and pulmonary infection were compared between the two groups after surgery. Results Compared with control group (group C), WBC and NEU counts significantly decreased at T3-5 in group LD (P ＜0.05). The serum concentrations of TNF-α, IL-6, MDA and RI significantly decreased at T2-5, while the SOD concentrations increased at T2-5 (P ＜0.05). Cstat and OI increased at T3-5 in group LD (P ＜0.05), while the the mechanical ventilation time, ICU stay time significantly decreased in group LD (P ＜0.05). Conclusion An arterial line leukocyte depletion during cardiopulmonary bypass can inhibit inflammatory responses and improve the postoperative pulmonary function after cardiopulmonary bypass.关键词
白细胞滤器/体外循环/全身炎症反应/肺功能/心脏手术/瓣膜置换Key words
Leukocyte depletion/Cardiopulmonary bypass/Systemic inflammatory response/Pulmonary function/Cardiac surgery/Valve replacement引用本文复制引用
罗琳,王丹,李美霞,陈梅珠..体外循环中动脉路白细胞滤除对心脏手术后患者肺功能影响的随机对照研究[J].中国体外循环杂志,2019,17(1):36-40,5.基金项目
海南省自然科学基金 (817385) （817385）
