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目的探讨持续超滤在婴幼儿体外循环心内直视手术中的应用价值。方法将50例先天性心脏病患儿随机分为对照组和实验组。对照组作常规体外循环,不应用超滤;实验组在体外循环中应用持续超滤,观察患儿血浆中白细胞介素-6(IL-6)、肿瘤坏死因子(TNF)血浆浓度、红细胞压积(HCT)、白蛋白浓度、肺功能及术后恢复时间等指标。结果与对照组比较,实验组体外循环后IL-6、TNF血浆浓度明显降低,HCT和血白蛋白浓度明显升高,肺功能损害减轻,术后恢复时间缩短(P均<0.05)。结论体外循环采用持续超滤,可有效排除部分炎症介质,浓缩血液,减轻肺水肿和肺损伤,促进术后恢复。
Objective To investigate the value of continuous ultrafiltration in open heart surgery of infants and children undergoing cardiopulmonary bypass. Methods 50 cases of congenital heart disease were randomly divided into control group and experimental group. The control group was subjected to conventional cardiopulmonary bypass without ultrafiltration. The experimental group was treated with continuous ultrafiltration during cardiopulmonary bypass. The levels of plasma interleukin-6 (IL-6), tumor necrosis factor (TNF), plasma erythrocyte Product (HCT), albumin concentration, lung function and postoperative recovery time and other indicators. Results Compared with the control group, the plasma concentrations of IL-6 and TNF were significantly decreased, the HCT and serum albumin concentrations were significantly increased, the pulmonary function impairment was relieved, and the recovery time was shorter after CPB (P <0.05). Conclusion Continuous ultrafiltration of cardiopulmonary bypass can effectively exclude some inflammatory mediators, blood concentration, reduce pulmonary edema and lung injury, and promote postoperative recovery.