中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

婴儿深低温体外循环术后肺表面活性物质的变化

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目的 比较婴儿先天性心脏病在深低温停循环 ( DHCA)或深低温低流量 ( DHL F)下行心内直视手术后肺表面活性物质 ( PS)活性水平的变化。 方法 根据采用的体外循环 ( CPB)方法不同 ,将 2 0例室间隔缺损伴肺动脉高压的婴儿分为 DHCA组和 DHL F组 ,每组 10例。测定 CPB前 ,CPB结束 5分钟和 2小时时 PS活性水平的饱和卵磷脂 /总磷脂 ( Sat PC/ TPL )和饱和卵磷脂 /总蛋白 ( Sat PC/ TP)值和肺静态顺应性。 结果  DHL F组术后住 ICU时间明显长于 DHCA组 ( Plt;0 .0 5 ) ,DHL F组术后 Sat PC/ TPL、Sat PC/ TP和肺静态顺应性下降的幅度均明显大于DHCA组 ( Plt;0 .0 1)。 结论  DHL F较 DHCA更能引起 PS活性水平的降低 ,从而引起更严重的肺损伤。

Objective To compare the changes between deep hypothermic circulatory arrest (DHCA) with deep hypothermic low flow (DHLF) cardiopulmonary bypass (CPB) on pulmonary surfactant (PS) activity in infants with congenital heart disease. Methods Twenty infants with ventricular septum defect and pulmonary hypertension were assigned to either DHCA group or DHLF group according to the CPB methods respectively. Measurements of saturated phosphatidylcholine /total phospholipids (SatPC /TPL), saturated phosphatidylcholine/ total protein (SatPC/TP) and static pulmonary compliance were performed before institution of CPB, 5 minutes after cessation of CPB and 2 hours. Results The length of ICU stay in DHLA group was significantly longer ( P lt;0 05) than that in DHCA group. SatPC/TPL, SatPC/TP and static pulmonary compliance in DHLF group were significantly lower compared with DHCA group ( P lt;0.01). Conclusion DHLF could lower the PS activity level significantly as compared with DHCA in infants with congenital heart disease.

关键词: 深低温停循环; 深低温低流量; 肺表面活性物质; 婴儿

Key words: Deep hypothermic circulatory arrest; Deep hypothermic low flow; Pulmonary surfactant; Infant

引用本文: 孙勇,苏肇伉,杨艳敏,等. 婴儿深低温体外循环术后肺表面活性物质的变化. 中国胸心血管外科临床杂志, 2004, 11(2): 96-98. doi: 复制

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