去白细胞血预充对婴儿体外循环的肺保护作用.pdfVIP

· 论 善 · J Med Res，June 2008，Vo1．37 No．6 去白细胞血预充对婴儿体外循环的肺保护作用 高鲁燕 陈子民 王 涛 摘 要 目的 研究去白细胞血预充对围体外循环期(CPB)婴儿肺功能的影响。方法 60例1岁室间隔缺损患儿，随机 分成实验组和对照组，实验组用去白细胞血预充，对照组用常规库血预充。检测CPB开始前、CPB结束后2、6、12、24和48h 6个 时点的氧合指数(OI)、动脉血氧分压／肺泡氧分压(PaO：／PAO：)、肺泡一动脉氧分压差(A—aDO：)和呼吸指数(RI)等肺功能指 标。结果 OI、PaO2／PAO2在CPB后2h、6h、12h时点实验组高于对照组(P0．01，P0．05)；A—aDO 在CPB后2h、6h、12h、48h 时点实验组低于对照组(P0．01，P0．05)；RI在CPB后6h、12h实验组低于对照组(P0．01，P0．05)。结论 去白细胞血 预充可改善围体外循环婴儿早期肺脏的氧合功能，具有良好的肺保护作用。 关键词 体外循环 白细胞 肺保护 Lung Protection Due to Leukocyte—removed Priming Fluid P 一cardiopulmonary Bypass in Infants． Gao Luyan，Chen Zimin，Wang Tao．Cardiovascular Center，Shenzhen Children’S Hospital，China Medical University，Guangdong 518026，China Abstract Objective To investigate the impact of leukocyte—removed priming fluid on lung function peri—CPB in infants．Meth- ods Selected 60 infants of less than 1一year—old，with ventricular septal defect(VSD)，were randomly assigned to the experimental group and the control group，the experimental group took blood leukocyte—removed priming fluid，and the control group took banked blood—derived priming fluid．Indicators of OI，PaO2／PAO2，A —aDO2 and R1 were recorded at the corresponding period of cardiopulmo— nary bypass(pre—CPB，2h，6h，12h，24h and 48h post—CPB)．Results At 2h，6h，12h post—CPB，OI and PaO2／PAO2 ofthe ex- perimental group were higher than those of the control group(P0．01，P0．05)．A—aDO2 of the experimenml group was lower than that of the control group at 2h，6h，12h，48h post—CPB(P0．01，P0．05)．RI of the experimental group was lower than that of the control group at 6h，12h post—CPB(P0．0l，P0．05)．Conclusion The measures of leukocyte—removed priming fluid can improve early oxygenation of lungs，and have good lung protection post—CPB in infants． Key words Cardiopulmonary bypass；White blood cell；Lung protection 随着体外循环(cardiopulmonary bypass，CPB)技