米力农在心脏瓣膜置换术中的肺保护作用-外科学专业毕业论文.docx

宁夏医科大 宁夏医科大学硕士研究生学位论文 ABSTRACT II II The Protective Effect of Milrinone on Lung in Cardiac valve Replacement Surgery ABSTRACT Objective To study the protective effect of Milrinone on lung in cardiac valve replacement surgery and the prevention and treatment of acute lung injury after cardiopulmonary bypass and its principl es. Methods 40 patients undergoing valve replacement surgery were randomly divided into milrinone group (group M) and control group (group C), 20 cases each. The patients in group M were given milrinone in a loading dose of 50μ g/kg before anesthesia induction,followed by a continuous intravenous infusion of 0.5μ g/kg/min; and Group C at the same rate infusion of normal saline . Blood samples were taken from radial artery before anesthesia induction (T1), at 10 minutes of CPB (T2), and at 2 hours (T3), 6 hours (T4) after the operation. Measured the TNF-α , IL-6 and IL -10 level; Artery blood gas analysis was done at 4 hours after the operation and calculated OI,A -aDO2 and RI ,Recorded t ime of mechanical ventilation and pulmonary artery systolic pressure. Results Compared with T1 , TNF-α , IL-6 activity increased significantly from T2 to T4 in both groups, but those levels in group M were significantly lower in group C; compared with T1 , IL-10 activity increased significantly from T2 to T4 in both groups, but IL-10 in group M were significantly higher than that in group C(P 0.05 or P 0.01). OI, group M was significantly higher than group C(P 0.05); A -aDO2 , RI,PASP, mechanical ventilation time, group M were significantly lower III III than group C (P 0.05). Conclusion Milrinone can play a significant role in lung protection during Cardiopulmonary bypass . KEYWORDS Milrinone,Cardiopulmonary bypass,Acute Lung Injury 宁夏医科大 宁夏医科大学硕士研究生学位论文 符号说明 PAGE PAGE IV 符 号 说 明 英文缩写 英文全称 中文全称 CPB Cardiopulmonary bypass 体外循环 SIRS Systemic inflammatory respon se syndrome 全身炎症反应综合征 ALI Acute lung injury 急性肺损伤 ARDS Acute Respiratery Distress S yndrome 急性呼吸