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|本期目录/Table of Contents|

肺开放通气对体外循环术后急性肺损伤婴幼儿呼吸力学和血流动力学的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第6期
页码:
798-800，803
栏目:
临床研究
出版日期:
2011-12-25

文章信息/Info

Title:
Effect of open lung ventilation on respiratory mechanics and haemodynamics in acute lung injury infants after cardiopumonary bypass
作者:
赵 堃; 赵 荣; 马 超; 李继科; 贺 清; 张鑫浩; 郑 云
第四军医大学西京医院心血管外科，陕西 西安 710032
Author(s):
ZHAO Kun;  ZHAO Rong;  MA Chao;  LI Ji-ke;  HE Qing;  ZHANG Xin-hao;  ZHENG Yun
Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
关键词:
肺开放; 新生儿; 急性肺损伤; 体外循环; 血流动力学
Keywords:
open lung;  infants;  acute lung injury;  cardiopulmonary bypass;  hemodynamics
分类号:
R826.63
DOI:
-
文献标识码:
A
摘要:
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。
Abstract:
AIM:To investigate the effects of open lung ventilation on the haemodynamics and respiratory mechanics in infants with acute lung injury (ALI) after cardiopulmonary bypass (CPB). METHODS: Sixty-four infants with ALI undergoing open-heart surgery were randomized into Group A of no-lung recruitment maneuver (N-LRM), with only low tidal volume, and Group B of lung recruitment maneuver (LRM), with low tidal volume and lung recruitment maneuver remedy. RESULTS: The oxygenation was remarkably improved after LRM in group B. PaO2 in Group B was significantly higher than that in group A ［(284±19) mmHg vs. (78±18) mmHg, P< 0.01］ and the respiratory mechanics in group B was superior to those in group A. No significant difference was observed in the haemodynamics between the two groups. CONCLUSION: LRM improves the oxygenation and the respiratory mechanics but has no obvious side effect on haemodynamics in infants with ALI after cardiopulmonary bypass.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2010-11-30.通讯作者：赵荣，副教授，主要从事心血管外科危重病人监护 与救治研究Email:zhaorong@fmmu.edu.cn 作者简介：赵堃，硕士生Email:ken826@foxmail.com
更新日期/Last Update: 2011-12-27