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经升主动脉注射鱼精蛋白的肺保护作用 被引量：3

Lung protection effect of intra-aortic protamine injection in infants underwent opening heart operation by cardiopnimonary bypass surgery
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摘要 目的探讨经升主动脉注射鱼精蛋白对婴幼儿体外循环心脏直视手术的肺保护作用。方法60例（年龄≤1岁，体重≤10kg）行体外循环心脏直视手术患儿，随机分为升主动脉组和中心静脉组各30例，比较2组注射鱼精蛋白前和注射鱼精蛋白后10min、1h、3h气道峰压（Ppeak）、气道平台压（Pplate）及肺顺应性（CL）、氧合指数（OI）、肺隔离白细胞、中性粒细胞计数和术后呼吸机辅助通气时间的差异。结果在注射鱼精蛋白1、3h后，升主动脉组肺隔离白细胞、中性粒细胞计数、Ppeak、Pplate较中心静脉组明显减低（t值分别为2．743、3．512，3．218、3．469，3．716、5．243，3．853、4．783，P均〈0．05），升主动脉组CL及OI较中心静脉组明显增高（t值分别为3．976、4．267，4．557、4．265，P均〈0．05）；升主动脉组较中心静脉组呼吸机辅助通气时间明显缩短[（8．03±5．14）、（10．56±6．95）h，t=2．599，P〈0．05]。结论经升主动脉注射鱼精蛋白能够减轻体婴幼儿体外循环心脏直视手术肺损伤，是一种良好的肺保护措施。 Objective To study the protective effect of intraaortic protamine injection on lung in infants undergwent opening heart operation by cardiopulmonary bypass surgery. Methods Sixty infants （ age ≤ 1 year, weight ≤ 10 kg）who accepted opening heart operation by cardiopulmonary bypass surgery were randomly assigned into 2 groups （ n = 30 in each group） reciving intra-aortic and intra-venous protamine injection respectively. P- peak, P-plate, CL, Oxygenation Index, the number of WBC and neutrophil segregated in lungs were compared between two groups before injecting protamine and 10 minutes, 1 hour, 3 hours after injecting protamine. The time of mechanical ventilation were compared as well. Results P-peak, P-plate, the number of WBC and neutrophil segregated in lungs of intra-aortic injection group significantly decreased than intra-venous injection group at 1 hour, 3 hours after injecting protamine （t =2. 743, 3.512; 3. 218, 3.469; 3.716, 5. 243; 3. 853, 4. 783 respectively, Ps 〈 0. 05 ）, while the CL and Oxygenation Index increased significantly （ t = 3. 976, 4. 267; 4. 557,4. 265 respectively, P 〈0. 05 ）. The duration of mechanical ventilation follow operation in intra- aortic injection group （ [ 8. 03 ± 5.14 ] h ） was shorter compared with intra-venous injection group （ [ 10. 56 ± 6.95 ] h） （ t = 2. 599, P 〈 0. 05 ）. Conclusion By intra-aortic protamine injection the lung injury decreased significantly. It shows good protective effect on lung in infants underwent opening heart operation by cardiopulmonary bypass surgery.
作者 孟保英 张青 王涛 沈定荣 彭乐 马超 潘晓兰 王元祥
机构地区 广东省深圳市儿童医院心血管科
出处 《中国综合临床》 2011年第3期235-238,共4页 Clinical Medicine of China
基金 深圳市科技计划项目（200802063）
关键词 体外循环 肺损伤 鱼精蛋白 婴幼儿 Cardiopulmonary bypass surgery Lung injury Protamine Infants
分类号 R654.2 [医药卫生—外科学]
  • 相关文献

参考文献13

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二级参考文献34

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共引文献20

同被引文献25

  • 1张新日,杜永成,姜宏英,许建英,徐永健.中性粒细胞活化在呼吸机所致肺损伤中的作用[J].中国危重病急救医学,2005,17(6):367-369. 被引量：21
  • 2李荣,杨筠,岳庆祝,张曼丽,赵伟.心脏手术中鱼精蛋白不良反应与综合预防措施和不同注射途径相关性的研究[J].中国医师杂志,2005,7(10):1385-1387. 被引量：4
  • 3陈自力,竺娣,李建华,张泽伟.儿童体外循环围术期支气管肺泡灌洗液中IL-8的变化及意义[J].浙江预防医学,2006,18(1):10-12. 被引量：4
  • 4PANOS A, ORRIT X, CHEVALLEY C, et al. Dramatic post- cardiotomy outcome,due to severe anaphylactic reaction to protamine[J]. Eur J Cardiothorac Surg, 2003, 24(2) : 325- 327.
  • 5BALHOM R. The protamine family of sperm nuclear protcins[J]. Genome Biol, 2007, 8(9) : 227.
  • 6NYBO M, MADSEN J S. Serious anaphylactic reactions due to protamine sulfate:a systematic literature review[J]. Basic Clin Pharmacol Toxicol, 2008, 103 (2) : 192-196.
  • 7MAYUMI H, TOSHIMA Y, TOKUNAGA K. Pretreatment with H2 blocker famotidine to a meliorate protamine induced hypotension in open-heart surgery[J]. J Cardiovasc Surg, 1992, 33(6) : 738-748.
  • 8KINDLER C, BIRCHER A, STULZ P. Protamine-induced fulminating non-cardiogenic pulmonary edema following cardiopulmonary bypass. Protamine-induced fulminating non- cardiogenic pulmonary edema following cardiopulmonary bypass [J]. Eur J Cardiothorac Surg, 1996, 10(6) : 463-466.
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引证文献3

二级引证文献8

中国综合临床
2011年 第3期

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