Rein K A, Semb K, Myhre H O, Levang O W, Christensen O, Stenseth R, Sande E
Department of Surgery, Trondheim Regional Hospital, Norway.
Scand J Thorac Cardiovasc Surg. 1988;22(3):267-70. doi: 10.3109/14017438809106073.
Colloid osmotic pressure in plasma (COPpl) from a cubital vein and in interstitial fluid (COPif) in the subcutaneous tissue at heart level, and interstitial fluid pressure (Pif) at the same level, were measured in 18 healthy subjects and in 28 patients requiring aortocoronary bypass. Interstitial fluid was collected via subcutaneously implanted double nylon wicks and Pif was measured with the 'wick-in-needle' technique. Measurements were made preoperatively and 1 1/2 to 8 hours (mean 4 hours) after termination of extracorporeal circulation. Pif rose to 2.3 mmHg above the pre-bypass level. COPpl concomitantly fell from 22.2 to 14.4 and COPif from 12.4 to 10.1 mmHg. These changes were statistically significant. Although the relatively large COPpl drop resulted in a net rise of 3.2 mmHg in filtration pressure, the incidence of pulmonary complications was low and no subcutaneous edema was discernible. The fall in COPif and rise in Pif may be regarded as important edema-preventing mechanisms.
在18名健康受试者和28名需要进行主动脉冠状动脉搭桥手术的患者中，测量了肘静脉血浆中的胶体渗透压（COPpl）、心脏水平皮下组织间质液中的胶体渗透压（COPif）以及同一水平的间质液压力（Pif）。通过皮下植入的双尼龙芯收集间质液，并用“针内芯”技术测量Pif。在体外循环结束前和结束后1.5至8小时（平均4小时）进行测量。Pif升至比搭桥前水平高2.3 mmHg。COPpl随之从22.2降至14.4，COPif从12.4降至10.1 mmHg。这些变化具有统计学意义。尽管COPpl的较大下降导致滤过压净升高3.2 mmHg，但肺部并发症的发生率较低，且未发现皮下水肿。COPif的下降和Pif的升高可被视为重要的预防水肿机制。
