摘要
目的:探究平衡超滤加改良超滤对婴幼儿体外循环术后肺功能的影响。方法:对我院2009年7月-2011年3月收治的45例先天性心脏病患儿按照随机数字表进行平均分组,分别为平衡超滤联合改良超滤组、改良超滤组及对照组,各15例,分别使用平衡超滤联合改良超滤、改良超滤及单纯体外循环治疗,观察三组患儿转流各时间段呼吸情况、炎性因子浓度及肺功能变化,分析平衡超滤加改良超滤对婴幼儿体外循环术后肺功能的影响。结果:体外循环结束后20 min三组患儿血清IL-6、TNF-α指标明显升高,且C组及M组较U组明显升高,而C组及M组组间比较无明显统计学差异;T4、T5时点三组患儿TNF-α浓度逐渐下降,U组较C组及M组下降明显,sICAM-1浓度明显高于T1时点,且C组及M组较U组明显升高,而C组及M组组间比较无明显统计学差异;三组患儿肺静态顺应性明显降低,肺泡-动脉氧分压梯度明显升高;T3及T4时点U组、M组患儿肺静态顺应性及氧合指数均明显高于C组,而肺泡-动脉氧分压梯度明显低于C组;U组肺静态顺应性及氧合指数明显高于M组和C组,且肺泡-动脉氧分压梯度明显低于后者。结论:体外循环疗法治疗先天性心脏病会不可避免地引起机体炎症反应,而应用平衡超滤加改良超滤可最大限度减轻炎症反应带来的并发症,降低患儿肺损伤发生风险,提高预后,保证生存质量。
Objective： To study the effects of balanced and modified ultrafiltration on pulmonary function after cardiopulmonary bypass in infants.Methods： 45 cases who were enrolled in our hospital from July 2009 to March 2011 were selected and divided into three groups.according to the random number table,respectively,balance ultrafiltration and modified ultrafiltration group,modified ultrafiltration group and control group,each 15 cases respectively,using balance ultrafiltration and modified ultrafiltration,modified ultrafiltration and simple extracorporeal treatment,observation of three groups of children with bypass each time changes of respiratory conditions,the concentration of inflammatory factors and pulmonary function,analysis of the effect of balanced ultrafiltration and modified ultrafiltration on pulmonary function after cardiopulmonary bypass in infants.Results： After cardiopulmonary bypass in 20 serum min three groups.IL-6,TNF-α index of three groups were increased significantly,and the C group and M group was significantly higher when compared with U group,C group and M group.There was no significant difference among the three groups;T4,T5 time point in TNF-α concentration decreased gradually,U group than C group.And M group decreased significantly,the concentration of sICAM-1 was significantly higher than that of T1 point,and in C group and M group was significantly higher compared with U group,C group and M group was no significant difference between the three groups of children;static lung compliance decrease,alveolar-arterial oxygen increased pressure gradient;T3 and T4 at U group,M group with static lung compliance and oxygenation index were significantly higher than that in C group,while the alveolar-arterial oxygen gradient was significantly lower than that in C group;group U,static lung compliance and oxygenation index was significantly higher than that in M group and C group,and alveolar-arterial oxygen gradient was significantly lower than the latter.Conclusion： It is inevitably that caused inflammatory reaction by extra corporeal therapy on the treatment of congenital heart disease,and the application of balanced ultrafiltration and modified ultrafiltration can maximize the inflammation caused by complications,reduce the risk of lung injury in children,improve the prognosis,and ensure the quality of life.
出处
《现代生物医学进展》
CAS
2013年第16期3091-3094,共4页
Progress in Modern Biomedicine
关键词
平衡超滤
改良超滤
先天性心脏病
体外循环
影响
Balanced ultrafiltration
Modified ultrafiltration
Congenital heart disease
Cardiopulmonary bypass
Influence
