Liu Li-ming, Hu Jian-guo, Yin Bang-liang, Yang Yi-feng, Zhang Wei, Yi Ding-wu, Liu Shao-qun
Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2005 Aug;30(4):413-6.
To determine the lung protection of continuous pulmonary artery perfusion with oxygenated blood during cardiopulmonary bypass (CPB).
Thirty patients undergoing mitral valve replacement were randomly divided into the control group (n=15) and the lung perfusion group (n=15). The patients in the lung perfusion group were perfused oxygenated blood continuously to the pulmonary artery during CPB. The patients in the control group were performed the routine procedure of mitral valve replacement. Record the CPB time, aortic cross-clamp time, mechanical ventilation time and ICU monitoring time. The patients' oxygen index (OI) and lung static compliance (Cstat) were measured before the surgery, at 0 h after the CPB and at 0, 6 h after the surgery. Right lung biopsy specimens were obtained at 30 min after the CPB to observe the histological changes. Results The mechanical ventilation time and ICU monitoring time were shorter in the lung perfusion group than those in the control group (P < 0.05). The patients' OI and Cstat were higher after surgery in the lung perfusion group than those in the control group (P < 0.05). Tissue examination showed lung parenchyma edema and inflammatory cells accumulated in the control group, while no remarkable pathological changes occurred in the lung perfusion group.
Lung injury exists after the surgery by CPB. Continuous pulmonary artery perfusion with oxygenated blood during CPB can decrease the lung injury.
探讨体外循环（CPB）期间持续肺动脉灌注氧合血对肺的保护作用。
将30例行二尖瓣置换术的患者随机分为对照组（n = 15）和肺灌注组（n = 15）。肺灌注组患者在CPB期间持续向肺动脉灌注氧合血。对照组患者行常规二尖瓣置换术。记录CPB时间、主动脉阻断时间、机械通气时间和ICU监测时间。分别于术前、CPB后0 h、术后0、6 h测定患者的氧合指数（OI）和肺静态顺应性（Cstat）。CPB后30 min取右肺活检标本观察组织学变化。结果肺灌注组的机械通气时间和ICU监测时间均短于对照组（P < 0.05）。肺灌注组术后患者的OI和Cstat高于对照组（P < 0.05）。组织学检查显示对照组肺实质水肿，有炎性细胞浸润，而肺灌注组未见明显病理改变。
CPB术后存在肺损伤。CPB期间持续肺动脉灌注氧合血可减轻肺损伤。
