摘要
目的观察在婴幼儿心内直视手术中库血预充液采用零平衡超滤(ZBUF)后对机体炎性反应的影响。方法20例体重<10kg、在体外循环(CPB)下行心内直视手术的婴幼儿,按随机数字表法分为两组。对照组(n=10):常规采用库血预充;ZBUF组(n=10):在常规库血预充的基础上对预充液进行ZBUF,晶体预充液及平衡置换液均选用复方氯化钠溶液,ZBUF时间12.00±1.25 min,滤液量共300ml。对比超滤前后预充液的改变,观察CPB过程中两组患者血流动力学、炎性因子及生化等指标的改变。结果ZBUF组在常规库血预充液混合、采用ZBUF300ml后,其二氧化碳分压(PCO2)、K+、乳酸(LAC)、葡萄糖(GLU)、肿瘤坏死因子α(TNF-α)和白细胞介素8(IL-8)均较对照组低,氧分压(PO2)较对照组高(P<0.01)。CPB过程中两组患者平均动脉压(MAP)、血浆TNF-α和血GLU比较差别无统计学意义(P>0.05),而LACI、L-8浓度和带管时间ZBUF组低于或短于对照组(P<0.05,0.01)。结论ZBUF可以滤除CPB库血预充液中的炎性介质、K+、LAC和GLU,经ZBUF调整后的库血预充液在维持CPB期间的血流动力学和保护重要器官功能方面具有一定的作用。
Objectives To observe the effects on the systemic inflammatory responses of zero-balanced uhrafihration （ZBUF） used in stored blood priming solution of cardiopulmonary bypass （CPB） in infants open heart surgery. Methods Twenty infants whose weight less than 10kg underwent the open heart surgery were divided into two groups infants according to the random number table, control group （n = 10）： stored blood was conventionally primed; ZBUF group （n= 10）： the ZBUF technique was used in priming solution based on the conventional stored blood priming. Solution of compound sodium chloride were chosen as crystalloid priming solution and balance exchange solution. Ultrafihration time were 12. 00±1. 25 rain and filtrated volume was 300 ml. The changes of the priming solution before and after the ZUBF, the variety of hemodynamic parameters and inflammatory media in CPB of two groups were observed. Results After 300ml volume ZBUF to the completely mixed conventional stored blood priming solution, the pressure of carbon dioxide（PCO2）, concentration of potassium （K^＋ ）, lactic acid （LAC）, glucose （GLU）, tumor necrosis factor α （TNF-α） and interleukin-8 （IL-8） in ZBUF group were lower than those in control group; and the pressure of oxygen（PO2） was higher than that in control group （P〈 0.01）. During CPB progress, mean artery pressure （MAP）, plasma TNF-α and GLU had no statistic differences between two groups infants （P〈0.05）, but LAC, IL-8 and tubing ventilation time in ZBUF group infants were lower or shorter than those in control group （P〈0. 05,0. 01）. Conclusion ZBUF can take out of the inflammatory media, K^＋, LAC, and GLU from the stored blood priming solution of CPB. The stored blood priming solution modulated by ZUBF may be beneficial to hemodynamic situation and the function of the main organs during CPB.
出处
《中国胸心血管外科临床杂志》
CAS
2005年第6期396-398,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
零平衡超滤
库血
预充液
婴幼儿
心脏手术
Zero-balanced uhrafihration
Stored blood
Priming solution
Infant
Heart surgery
