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1、临床评估五种膜式氧合器在不同温度下跨膜压差作者：刘瑞芳，邢家林，缪娜，柳薇，吉冰洋【摘要】目的评估五种中空纤维膜式氧合器(HFMO)在体外循环(CPB)中不同温度下的跨膜压差(TMPD)。方法40例择期CPB下行心脏直视手术患者依据使用HFM0的不同随机分为五组(每组8例)：A组(Affinty),C组(Cobe),J组(Jostra),P组(Polystan)和T组(Terumo)。在CPB全流量后(T1)、最低温度时(T2)、复温后(T3)监测灌注流量、鼻咽温度、红细胞比积、平均动脉压，并在
2、HFM0的入口和出口处监测压力的变化。结果各组术前的临床参数没有显著性差异(P>；0.05)oTMPD在不同的时点J组为最小，其他依次分别为A组0.05)。A组、P组和T组在低温过程中的TMPD分别高于T1和T3,但没有显著性差异(P>；0.05)o结论J组和A组的TMPD较低可能更有利于减少对血细胞的破坏，更适合应用于CPB时间较长的心脏手术。【关键词】膜式氧合器;跨膜压差；体外循环；温度Abstract：OBJECTIVEToevaluatefivetypecommercialava
3、ilableoxygenatorsofthetrans-membranepressuredrop(TMPD)duringnormothermicandhypothermiccardiopulmonarybypass(CPB)・METHODSFortypatientsscheduledforcardiacsurgeryparticipatedthisstudyandweredividedintofivegroups(n二8,inper-group)accordingtotypeofoxygenat
4、orsusedduringCPB：groupJ(JoatraQuardox),groupA(AffinityNT),groupP(PolystanSafeMaxi),groupT(TerumoCapioxSX)andgroupC(COBEAPEX-TM).ParameterswerecollectedduringCPBincludingmeanarterialpressure,pumpflow,temperature,hematocritandTMPDatpre-andpost-oxygenat
5、orduringnormothermic(Tl),hypothermic,28°C(T2)andafterrewarming(T3).RESULTSTherewasnosignificantdifferenceamongfivegroupsinpre~operativeclinicalparameters(P>；0・05)・TMPDsofgroupJwerethelowestindifferenttime-points,followedbytheothergroupweregroupA&It
6、；groupPgroupT&It；groupC.TMPDofgroupJandAcomparedtotheotherthreegroupswerelower(P&It；0.01)respectivelyandJwassignificantlowerthangroupAatT2(P<；0.01).ExceptTMPDsofgroupPweresignificantlylowerthangroupC(P<；0・01)atTl,therewerenostatisticalsignificanc
7、e(P>；0.05)invarioustime-points.AlthoughTMPDsingroupA,PandTduringT2werehigherthanT1andT3,buttherewerenostatisticalsignificance(P>；0.05)invarioustime-points.CONCLUSIONTheTMPDofHFMOsingroupJandAproducedsignificantlylowerandduringnormothermicandhypot
8、hermicCPB,thusbloodtraumawiththesetwoHFMOsduringCPBmaybesignificantlylowercomparedtotheotherthree・Keywords:Membraneoxygenato；Pressuredrop；Cardiopulmonarybypass；Hyperthermia随着生物医学工程技术的进步，中空纤维膜式氧合器(hollow-fibermembraneoxygenators,HFM0)的走血方式从纤维内走血变为纤维外走
