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|本期目录/Table of Contents|

改良超滤改善成人瓣膜替换术后左心功能(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第5期
页码:
405-407
栏目:
临床研究
出版日期:
2002-09-01

文章信息/Info

Title:
Modified ultrafiltration improves left ventricular function after replacement of adult′s valves
作者:
史信宝; 张志梁; 邵国丰; 黄长顺
宁波大学医学院附属李惠利医院,浙江宁波315040
Author(s):
SHI Xin-bao; ZHANG Zhi-liang; SHAO Guo-feng; HUANG Chang-shun
Ningbo Medical Center Li Huili Hospital,Attached to Medical College of Ningbo University,Ningbo,Zhejiang 315041,China
关键词:
改良超滤; 血液动力学; 心室功能; 成人瓣膜替换术
Keywords:
modified ultrafiltration; hemo dynamics; ventricular function; adult′s valves replacement
分类号:
R318.11
DOI:
-
文献标识码:
A
摘要:
目的 探讨改良超滤对成人瓣膜替换术后心功能的影响。方法 成人瓣膜替换术患者20例随机分成改良超滤组(MUF组)10例,对照组(C组)10例,用Swan-Ganz导管及Baxter心排出量监测仪,动态观察体外循环(CPB)前、停CPB时及MUF后或停CPB后15 min CO,CI,SV,SVI,LVSWI,RVSWI,MPAP,PAWP,SVR,PVR,CVP 及MAP。结果 MUF组超滤前后CO,CI,SV,SVI分别从4.18±0.61,2.77±0.53,49.3±15.4,31.9±11.1上升到5.17±0.58,3.26±0.34,59.0±14.2,36.9±8.6(P<0.05);MAP,LVSWI从10.6±0.6,31.8±12.1上升到12.4±1.0,41.9±9.6(P<0.01);SVR,PVR,MPAP,RVSWI变化无显著性意义。C组停CPB时与停CPB后15min各项指标差别无显著性意义。MUF组超滤后与C组停CPB后15 min比较,CI为3.26±0.34vs2.91±0.32(P<0.05),LVSWI为41.9±9.6vs33.7±9.3(P<0.05);SVI及RVSWI差别无显著性意义。结论 改良超滤在成人心脏直视术中,能通过减轻心肌水肿,增加心肌收缩力及顺应性,提高心指数,改善心功能。
Abstract:
AIM To test the hypothesis that the use of modified ultrafiltration(MUF) after cardiopulmonary bypass improves blood dynamics in adult′s valves replacement.METHODS Twenty adults patients who had undergone valves replacement were randomized to modified ultrafiltration(n=10) or as the control(n=10). They were instrumented with Swan-Ganz catheter and cardiac output inspective instrument of Baxter,to measure CO, CI, SV, SVI, LVSWI, RVSWI, MPAP,PAWP,SVR,PVR,CVP and MAP at pro-CPB,post-CPB and post-MUF or 15 min after CPB.RESULTS In the MUF group,CO,CI,SV,SVI at post-MUF increased from 4.18±0.61, 2.77±0.53,49.3±15.4,31.9±11.1 to 5.17±0.58,3.26±0.34,59.0±14.2,36.9±8.6(P<0.05);MAP,LVSWI at post-MUF increased from 10.6±0.6,31.8±12.1 to 12.4±1.0,41.9±9.6 (P<0.01);SVR,PVR,MPAP,RVSWI did not change(P>0.05). The changes were not significantly different from those of the control group. CI, LVAWI were 3.26±0.34,41.9±9.6 at post-MUF in the MUF group and 2.91±0.32,33.7±9.3 at 15 min after CPB in the control group(P<0.05).CONCLUSION The use of MUF in adult′s open-heart operation relieves myocardiac edema, improves myocardial contractility compliances,cardiac index and cardiac function.

参考文献/References

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[3] Davies MJ,Nguyen L,Gaynor JW,et al. Modified ultrafiltraion improves left ventricular systolic function in infants after cardiopulmonary bypass[J].J Throac Cardiovasc Surg,1998,115:361-370.

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备注/Memo

备注/Memo:
收稿日期：2001-05-21.基金项目:宁波市医学科研 (攻关 )计划项目 (99005)
更新日期/Last Update: 2002-09-01