目的:探讨肺开放治疗对体外循环(cardiopulmonary bypass,CPB)术后急性肺损伤(acute lung injury,ALI)婴儿血流动力学和呼吸力学的影响。方法:随机选取2008年3月～2010年7月西京医院心血管外科接受心脏手术的64例ALI婴幼儿,分为无肺复张治疗组(非肺复张组):采用小潮气量通气模式进行呼吸辅助及治疗,肺复张治疗组(肺复张组):在小潮气量通气模式下,加用肺开放治疗(lung recruitment maneuver,LRM)。结果:在肺复张治疗后,呼吸力学和氧合都有显著的改善,肺复张组的PaO2[(284±19)mmHg]明显高于非肺复张组[(78±18)mmHg](P<0.01)。肺复张组的呼吸力学指标显著优于非肺复张组,血流动力学指标无显著性差异。结论:LRM可以大大改善婴儿CPB术后ALI的氧合及呼吸力学。 Objective: To investigate the effects of open lung therapy on hemodynamics and respiratory mechanics in infants with acute lung injury (ALI) after cardiopulmonary bypass (CPB). Methods: Sixty-four ALI infants who underwent cardiopulmonary surgery in Xijing Hospital from March 2008 to July 2010 were randomly divided into two groups: non-pulmonary re-treatment group (non-pulmonary reperfusion group): small tidal volume ventilation Breathing assistance and treatment, pulmonary recurrent treatment group (lung recurrent group): In the small tidal volume ventilation mode, lung recruitment maneuver (LRM) was added. Results: Respiratory mechanics and oxygenation were significantly improved after pulmonary reexpansion. PaO2 [(284 ± 19) mmHg] in lung reexpansion was significantly higher than that in non-pulmonary reexamination [(78 ± 18) mmHg] (P <0.01). The respiration mechanics index in the lung reexpansion group was significantly better than that in the non-lung reexpansion group, and there was no significant difference in the hemodynamic indexes. Conclusion: LRM can greatly improve the oxygenation and respiration mechanics of ALI after CPB in infants.