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1、改良超滤体外循环对婴幼儿心内直视手术术后心肺功能影响[摘要]目的:探讨改良超滤(MUF)对婴幼儿心内直视手术术后心肺功能的影响。方法:将40例行体外循环(CPB)下心内直视手术的婴幼儿随机分为MUF组(n=20)和无超滤对照组(简称对照组,n=20),动态观察CPB前、CPB停机以及MUF结束时(对照组在CPB停机20min时)的血氧分压(PO2)及二氧化碳分压(PCO2)、术后呼吸机辅助呼吸时间、正性肌力药用量以及使用时间、左心室射血分数(LVEF)等心肺功能指标。结果:40例患儿无一例死亡。两组的PO2在CPB停机时与CPB停机前相比
2、均明显下降,但MUF组在MUF结束时明显回升,接近CPB前水平,而对照组仅轻度回升,但仍明显低于CPB前;CPB停机20min时MUF组PO2高于对照组。CPB停机后两组PCO2轻度升高,MUF后PCO2轻度下降,但组内、组间比较差异无统计学意义。术后MUF组呼吸机辅助时间、正性肌力药用量以及使用时间明显低于对照组。术后1周心脏超声心动图检查提示两组LVEF均较术前明显提高,但组间比较差异无统计学意义。结论:MUF有利于改善婴幼儿心内直视手术术后早期的心、肺功能。�[关键词]改良超滤;体外循环;心功能;肺功能;婴幼儿�
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3、R654.2[文献标识码]A[文章编号]1671-7562(2010)01-0044-04�doi:10.3969/j.issn.1671-7562.2010.01.012��Influenceofmodifiedultrafiltrationoninfant�scardiopulmonary�functionafteropenheartsurgery��WANGZhe-yan,LUOXuan,YAOHao,LIUChang,CHENBao-jun,�CAOBin,WANGDong-jin(DepartmentofCardiovascul
4、arSurgery,NanjingDrumTowerHospital,MedicalCollegeofNanjingUniversity,Nanjing210008,China)��[Abstract]Objective:Toinvestigatetheinfluenceofmodifiedultrafiltration(MUF)oninfant�scardiopulmonaryfunctionafteropenheartsurgerywithcardiopulmonarybypass(CPB).Methods:40infantswith
5、congenitalheartdiseaseswererandomlydividedintotheMUFgroup(n=20)andthecontrolgroup(n=20).ArterialbloodwasmeasuredtoinvestigatePO2andPCO2beforeCPBattheendofCPB,attheendofMUF(or20minutesafterCPBincontrolgroup).Besides,thedosesofdopamineand10LVEFbeforeandaftersurgerywerealsom
6、easured.Results:Noinfantsweredeadinourresearch.ComparedwiththelevelsofPO2beforeCPB,thelevelsofPO2ofthe2groupsweredecreasedsignificantlyattheendofCPB.ThelevelofPO2inMUFgroupwasincreasedsignificantlyattheendofMUF,anditwasclosetothelevelbeforeCPB,whilethelevelofPO2incontrolg
7、roupwasincreasedlightlyattheendofMUF,anditwaslowersignificantlythanthelevelbeforeCPB.ComparedwiththelevelofPO2incontrolgroup,thelevelofPO2inMUFgroupwasincreasedsignificantlyat20minafterCPB.ThelevelsofPCO2ofthe2groupswereincreasedlightlyafterCPB,anditslevelsweredecreasedli
8、ghtlyafterMUF,butthedifferencesbetweenthe2groupswerenotsignificant.Comparedwiththecontrolgroup,t
