
浏览全部资源
扫码关注微信
1. 重庆医科大学临床学院胸心外科
2. 北京阜外医院麻醉科
3. 重庆医科大学临床学院胸心外科,重庆,400016
4. ,北京,100037
纸质出版日期:2005,
扫 描 看 全 文
[1]向小勇,张永恒,胡金晓,蒋迎九.自体肺体外循环对心脏手术的肺保护作用[J].重庆医科大学学报,2005(02):292-295+317.
XIANG Xiaoyong, et al. Effect of autogenous oxygenator cardiopulmonary bypass on lung protection at cardiac surgery[J]. Journal of Chongqing Medical University, 2005,(2):292-295.
[1]向小勇,张永恒,胡金晓,蒋迎九.自体肺体外循环对心脏手术的肺保护作用[J].重庆医科大学学报,2005(02):292-295+317. DOI: 10.13406/j.cnki.cyxb.2005.02.037.
XIANG Xiaoyong, et al. Effect of autogenous oxygenator cardiopulmonary bypass on lung protection at cardiac surgery[J]. Journal of Chongqing Medical University, 2005,(2):292-295. DOI: 10.13406/j.cnki.cyxb.2005.02.037.
目的:探讨常规体外循环心脏手术后肺的损伤和自体肺体外循环对肺的保护作用。方法:选择2 4只健康杂种成年犬随机分为两组
每组12只
试验组为自体肺组
利用杂种犬自体肺作为氧合器;对照组为人工肺组
除利用人工鼓泡肺作为氧合器外
其它条件同试验组。动态监测所有杂种犬左、右心房白细胞计数和白细胞跨肺差值、肺动脉压、动脉血氧分压
并分别取体外循环前、后的肺标本(右肺下叶3cm×3cm×2cm)行病理学检查。结果:自体肺组与人工肺组体外循环过程中各时点动脉血氧分压差异无显著性(P <0 .0 2 ) ;自体肺组体外循环后
动脉血氧分压高于人工肺组
差异有显著性(P <0 .0 2 )。体外循环后白细胞跨肺差值自体肺组低于人工肺组
各时间点差异均有显著性(P <0 .0 2 ) ;体外循环后自体肺组肺动脉压低于人工肺组
其中第30、6 0、90min时间点差异有显著性(P <0 .0 2 )
自体肺组在整个体外循环过程中
肺动脉压低于2 0mmHg
且肺动脉压维持平稳;肺标本组织学检查发现自体肺组肺标本毛细血管瘀血、中性粒细胞聚集均比人工肺组轻
无肺水肿、肺不张、肺泡间隙正常
无明显肺组织损伤改变。结论:体外循环心脏手术由于白细胞的趋化性增强并隔离于肺组织中
从而引起肺损伤。自体肺体外循环技术在体外循环过程中能提供满意的氧合
Objective:To investigate lung injury and protective effect of autogenous oxygenator cardiopulmonary bypass(CPB) on lung after CPB.Methods:24 adult mongrels (weight 15±1kg) were randomly divided into two groups
12 for experimental group
in which the dog’s own lung was used as oxygenator;12 for control group
in which the artificial lung (bubble oxygenator) was used as oxygenator.Leukocyte count of right atrium and left atrium
difference of transpulmonary leukocyte
the pulmonary artery pressure
and the oxygen pressure of artery were measured during the perioperative period.And lung biopsies were obtained before and after CPB in both groups for microscope pathological examination.Results:Autogenous oxygenator CPB technique could provide satisfactory oxygenation during CPB.The oxygen pressure after CPB was significantly higher in the experimental group than that in the control group at different time points( P <0.02).The difference of transpulmonary leukocyte after CPB was significantly lower in the experimental group than that in the control group at different time points( P <0.02).The pulmonary artery pressure was significantly lower in the experimental group than that in the control group at the 30th
60th
90th time points( P <0.02).Histologic examination of lung tissue revealed that in control group there were more obvious intraalveolar hemorrhage
leukocyte adhesion and interstitial edema compared with experimental group.Conclusion:Leukocytic chemotaxis reinforcement and leukocyte sequestration lead to lung injury. The autogenous oxygenator CPB technique can provide satisfactory oxygenation and obtain better lung protection effect.
体外循环肺保护自体肺体外循环肺动脉压
Cardiopulmonary bypass(CPB)Lung protectionAutogenous oxygenator cardiopulmonary bypassPulmonary artery pressure
0
浏览量
61
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621