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如何产生低溶血的搏动血流?

How to produce a pulsatile flow with low haemolysis?

作者信息

Qian K X, Zeng P, Ru W M, Yuan H Y, Feng Z G, Li I

机构信息

Jiangsu University of Science & Technology, Zhenjiang, China.

出版信息

J Med Eng Technol. 2000 Sep-Oct;24(5):227-9. doi: 10.1080/03091900050204278.

Abstract

It is evident that a pulsatile flow is important for blood circulation because the flow pulsatility can reduce the resistance of peripheral vessels. It is difficult, however, to produce a pulsatile flow with an impeller pump, since blood damage will occur when a pulsatile flow is produced. Further investigation has revealed that the main factor for blood damage is turbulence shear, which tears the membranes of red blood cells, resulting in free release of haemoglobin into the plasma, and consequently leads to haemolysis. Therefore, the question for developing a pulsatile impeller blood pump is: how to produce a pulsatile flow with low haemolysis? The authors have successively developed a pulsatile axial pump and a pulsatile centrifugal pump. In the pulsatile axial pump, the impeller reciprocates axially and rotates simultaneously. The reciprocation is driven by a pneumatic device and the rotation by a dc motor. For a pressure of 40 mm Hg pulsatility, about 50 mm axial reciprocating amplitude of the impeller is desirable. In order to reduce the axial amplitude, the pump inlet and the impeller both have cone-shaped heads, and the gap between the impeller and the inlet pipe changes by only 2 mm, that is the impeller reciprocates up to 2 mm and a pressure pulsatility of 40 mm Hg can be produced. As the impeller rotates with a constant speed, low turbulence in the pump may be expected. In the centrifugal pulsatile pump, the impeller changes its rotating speed periodically; the turbulence is reduced by designing an impeller with twisted vanes which enable the blood flow to change its direction rather than its magnitude during the periodic change of the rotating speed. In this way, a pulsatile flow is produced and the turbulence is minimized. Compared to the axial pulsatile pump, the centrifugal pulsatile pump needs only one driver and thus has more application possibilities. The centrifugal pulsatile pump has been used in animal experiments. The pump assisted the circulation of calves for several months without harm to the blood elements and the organ functions of the experimental animal. The experiments demonstrated that the pulsatile impeller pump is the most efficient pump for assisting heart recovery, because it can produce a pulsatile flow like a diaphragm pump and has no back flow as occurs in a non-pulsatile rotary pump; the former reduces the circulatory resistance and the latter increases the diastole pressure in aorta and thus increases the perfusion of coronary arteries of the natural heart.

摘要

显然,脉动流对血液循环很重要,因为血流脉动性可降低外周血管阻力。然而,用叶轮泵产生脉动流很困难,因为产生脉动流时会发生血液损伤。进一步研究表明,血液损伤的主要因素是湍流剪切力,它会撕裂红细胞膜,导致血红蛋白游离释放到血浆中,进而导致溶血。因此,开发脉动叶轮血泵的问题是:如何产生低溶血的脉动流?作者先后开发了脉动轴流泵和脉动离心泵。在脉动轴流泵中,叶轮轴向往复运动并同时旋转。往复运动由气动装置驱动,旋转由直流电动机驱动。对于40 mmHg的脉动压力,叶轮轴向往复振幅约50 mm是理想的。为了减小轴向振幅,泵入口和叶轮都有锥形头部,叶轮与入口管之间的间隙仅变化2 mm,即叶轮往复运动2 mm,可产生40 mmHg的压力脉动。由于叶轮以恒定速度旋转,预计泵内湍流较低。在离心脉动泵中,叶轮周期性地改变其转速;通过设计带有扭曲叶片的叶轮来降低湍流,这使得血流在转速周期性变化期间改变其方向而不是大小。通过这种方式,产生了脉动流,并且湍流最小化。与轴流脉动泵相比,离心脉动泵只需要一个驱动器,因此有更多的应用可能性。离心脉动泵已用于动物实验。该泵辅助小牛循环数月,对实验动物的血液成分和器官功能没有损害。实验表明,脉动叶轮泵是辅助心脏恢复最有效的泵,因为它可以产生像隔膜泵一样的脉动流,并且没有非脉动旋转泵中出现的回流;前者降低循环阻力,后者增加主动脉舒张压,从而增加天然心脏冠状动脉的灌注。

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