超滤加改良超滤在急诊体外循环与应用.pdfVIP

超滤加改良超滤在急诊体外循环中的应用 姜冠华 张鲁英 梁家立 卢金峰 济南军区总医院心外科 250031 摘要 目的 临床评价急诊体外循环(cardiopulmonrealdypass， CPB)中 应用超滤技术抢救和治疗急诊危重病人的效果。方法 31例急诊CPB病人，CPB后或复 温时开始超滤，必要时应用改良超滤，超滤液500～3100ml。结果 29例痊愈出院，2 例死亡。1例死于心功衰竭无法停CPB，1例术后死于急性肾功衰竭。结论 超滤技术 应用于急诊CPB中，不仅滤出水份，提高血细胞比容和血浆胶体渗透压，还可超滤出炎 性介质、乳酸等。有利于减少术后并发症，提高手术成功率。 关键词:超滤;急诊体外循环;危重病人;浅低温 Theclinicalapplicationofultrafiltrationtechniqueinemergency cardiopulmonarybypass GuanhuaJiangLuyingZhangJialiLiangGuangfuZhangXiaozhouZhengBoZhangZhe YangYongZhangHaofeng,Sun Departmentofcardiovascularsurgery,GeneralhospitalofJinanmilitarydistrict, Jinan,250031 [Abstract]Objective Toevaluatetheeffectofultrafiltrationtechniqueinemergency cardiopulmonarybypassonremedyofheavypatients.MethodsIn32patientswith emergencyextracorporealcirculation,ultrafiltrationwereusedaftercardiopulmonarybypass orduringrewarming.Improvedultrafiltrationwereusedinessentialtime.Ultrafiltrateranged from500to3100ml. Results29patientswerecured.2patientsdied.Onepatientdiedof acuteheartfailureandinterruptiondifficultyofcardiopulmonarybypassduringoperation. Theotherdiedbecauseofacuterenalfailure.ConeulsionApplicationofultrafiltration tecniqueinemergencycardiopulmonarybypassmayfilteroffthewater,increasevolumeof packedredbloodcellsandplasmacolloidosmotic,especially,italsocanfilterout phlegrnasiamediumandlacticacid. Itisbeneficialtodecreasethepostoperative complicationsandincreasetheoperativeachievementratio. Keywords:ultrafiltration;emergencycardiopulmonarybypass;heavypatients; hypothermia 瘤坏死因‘ 虑出，而E 万 以及细 『危重患者由于 于血中乳酸的轻 文献报道血鞠 为 降低 急 诊 (