摘要
目的 :探讨改良超滤对成人瓣膜替换术后心功能的影响。方法 :成人瓣膜替换术患者 2 0例随机分成改良超滤组 (MU F组 ) 10例 ,对照组 (C组 ) 10例 ,用 Swan- Ganz导管及 Baxter心排出量监测仪 ,动态观察体外循环 (CPB)前、停 CPB时及 MUF后或停 CPB后 15 m in CO,CI,SV ,SVI,L VSWI,RVSWI,MPAP,PAWP,SVR,PVR,CVP及 MAP。结果 :MU F组超滤前后 CO,CI,SV,SVI分别从 4 .18± 0 .6 1,2 .77± 0 .5 3,4 9.3± 15 .4 ,31.9± 11.1上升到 5 .17± 0 .5 8,3.2 6± 0 .34,5 9.0± 14 .2 ,36 .9± 8.6 (P<0 .0 5 ) ;MAP,L VSWI从 10 .6± 0 .6 ,31.8± 12 .1上升到12 .4± 1.0 ,4 1.9± 9.6 (P<0 .0 1) ;SVR,PVR,MPAP,RVSWI变化无显著性意义。 C组停 CPB时与停 CPB后 15min各项指标差别无显著性意义。 MUF组超滤后与 C组停 CPB后 15 m in比较 ,CI为 3.2 6± 0 .34vs 2 .91± 0 .32(P<0 .0 5 ) ,L VSWI为 4 1.9± 9.6 vs 33.7± 9.3(P<0 .0 5 ) ;SVI及 RVSWI差别无显著性意义。结论 :改良超滤在成人心脏直视术中 ,能通过减轻心肌水肿 ,增加心肌收缩力及顺应性 ,提高心指数 。
AIM:To test the hypothesis that the use of modified ultrafiltration(MUF) after cardiopulmonary bypass improves blood dynamics in adult′s valves replacement. METHODS:Twenty adults patients who had undergone valves replacement were randomized to modified ultrafiltration( n =10) or as the control( n =10). They were instrumented with Swan Ganz catheter and cardiac output inspective instrument of Baxter,to measure CO,CI,SV,SVI,LVSWI,RVSWI,MPAP,PAWP,SVR,PVR,CVP and MAP at pro CPB,post CPB and post MUF or 15 min after CPB. RESULTS:In the MUF group,CO,CI,SV,SVI at post MUF increased from 4.18±0.61,2.77±0.53,49.3±15.4,31.9±11.1 to 5.17±0.58,3.26±0.34,59.0±14.2,36.9±8.6( P <0.05);MAP,LVSWI at post MUF increased from 10.6±0.6,31.8±12.1 to 12.4±1.0,41.9±9.6( P <0.01);SVR,PVR,MPAP,RVSWI did not change( P >0.05). The changes were not significantly different from those of the control group. CI, LVAWI were 3.26±0.34,41.9±9.6 at post MUF in the MUF group and 2.91±0.32,33.7±9.3 at 15 min after CPB in the control group( P <0.05). CONCLUSION:The use of MUF in adult′s open heart operation relieves myocardiac edema, improves myocardial contractility compliances,cardiac index and cardiac function.
出处
《心脏杂志》
CAS
2002年第5期405-407,共3页
Chinese Heart Journal
基金
宁波市医学科研 (攻关 )计划项目 (990 0 5 )
关键词
改良超滤
血液动力学
心室功能
成年人
瓣膜替换术
modified ultrafiltration
hemo dynamics
ventricular function
adult′s valves replacement
