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不同浓度氧通气对先天性心脏病患儿体外循环肺功能的影响 被引量：2

Impact of ventilation with different concentrations of oxygen on lung functions after cardiopulmonary bypass in children with congenital heart disease
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摘要 目的观察先天性心脏病(先心)患儿体外循环(CPB)前后采用不同浓度的氧通气对术后肺功能恢复的影响。方法 30例择期手术的非紫绀型先心患儿,随机分为两组。H组:100%FiO2组(n=15);L组50%FiO2组(n=15)。H组CPB前后CPB再灌注期开始后应用100%氧气机械通气,L组相应时间应用50%氧气机械通气。于CPB前,CPB后1、6 h同步抽取桡动脉、肺动脉混合静脉血做血气分析,并根据公式计算出氧合指数(PaO2/FiO2)、呼吸指数(RI)、肺内分流率(Qs/Qt),同时抽取静脉血检测氧化物歧化酶(SOD)、丙二醛(MDA)。结果两组患儿PaO2/FiO2在CPB后1h均较CPB前降低(P<0.05),CPB后6 h,L组的氧合指数恢复至CPB前水平,但H组仍明显低于CPB前(P<0.05),且低于同时点的L组(P<0.05)。在CPB后1 h,H组患儿的RI、Qs/Qt明显高于CPB前(P<0.05),且高于同时间点的L组患儿。CPB后1 h两组患儿血浆SOD活性均下降,MDA产生增加,H组SOD消耗较多(P<0.05),MDA含量高于L组(P<0.05)。结论先心患儿体外循环手术中予以50%氧气通气,能够减轻缺血再灌注氧自由基损伤,有利于改善肺的氧合功能。 Objective To observe the effects of ventilation with different concentrations of oxygen on lung functions after cardiopulmonary bypass（CPB） in congenital heart disease patients.Methods Thirty patients of elective surgery for noncyanotic congenital heart disease patients were randomly divided into two groups.Group H（n=15） received 100% oxygen before and after CPB and group L（n=15） received 50% oxygen at the corresponding time. Before CPB and 1 hour and 6 hours after CPB,blood sample were collected from the radial artery and pulmonary artery for gas analysis.A formula was used to calculate the oxygenation index（PaO2/FiO2）,respiratory index（RI） and pulmonary shunt ratio（Qs/Qt）.Meanwhile,venous blood was taken to measure superoxide dismutase（SOD） and malondialdehyde（MDA）.Results One hour after CPB,PaO2 and FiO2 of the two groups were lower than the levels before CPB.Six hours after CPB,PaO2/FiO2 were not different from the levels before CPB in group L,but remained significantly lower in group H.One hour after CPB,RI or Qs/Qt were higher than the levels before CPB in group H.The SOD activity decreased and MDA production increased in both groups,while the group H showed more consumption of SOD and higher MDA content than group L one hour after CPB.Conclusion Lung ventilation with 50% oxygen in children with congenital heart disease during extracorporeal circulation surgery can reduce ischemia-reperfusion oxygen radical damage and help to improve lung oxygenation.
作者 陆志强 陈惠裕
机构地区 南京医科大学第二附属医院麻醉科
出处 《实用临床医药杂志》 CAS 2012年第5期41-43,共3页 Journal of Clinical Medicine in Practice
基金 南京医科大学科技发展基金资助项目(07NUMU041)
关键词 先天性心脏病 体外循环 肺损伤 氧浓度 congenital heart disease cardiopulmonary bypass lung injury oxygen concentration
分类号 R541 [医药卫生—心血管疾病]
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参考文献6

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共引文献20

同被引文献37

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实用临床医药杂志
2012年 第5期

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