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膜式氧合器与鼓泡式氧合器对择期心脏手术中血小板计数及血小板大小影响的比较。

A comparison of the effects of membrane and bubble oxygenators on platelet counts and platelet size in elective cardiac operations.

作者信息

Trumbull H R, Howe J, Mottl K, Nicoloff D M

出版信息

Ann Thorac Surg. 1980 Jul;30(1):52-7. doi: 10.1016/s0003-4975(10)61202-7.

Abstract

To compare the effects of membrane and bubble oxygenators on platelet counts and the size of circulating platelets, serial hematocrits, platelet counts, and platelet sizing were measured in 23 patients undergoing elective cardiac operations. In 10 patients a bubble oxygenator was used and in 13, a SciMed membrane oxygenator. The two groups were statistically similar with respect to age, weight, time on bypass, and mean blood flow rates during bypass. It was found that platelet counts, when corrected for hemodilution, did not fall from control levels during or up to 24 hours after cardiopulmonary bypass in either group. In both groups, the relative number of platelets per gram of hemoglobin increased slightly during and after bypass, and this increase was significant in the bubble oxygenator group. The average size of circulating platelets increased only in the bubble oxygenator group, and then only in the one-day postoperative sample. These findings suggest that the membrane oxygenator offers no advantage with respect to preservation of platelets during cardiopulmonary bypass lasting up to 2 to 3 hours.

摘要

为比较膜式氧合器和鼓泡式氧合器对血小板计数及循环中血小板大小的影响,对23例行择期心脏手术的患者进行了连续血细胞比容、血小板计数及血小板大小测定。其中10例患者使用鼓泡式氧合器,13例使用SciMed膜式氧合器。两组患者在年龄、体重、体外循环时间及体外循环期间的平均血流速度方面具有统计学相似性。结果发现,校正血液稀释后,两组患者在心肺转流期间及术后24小时内血小板计数均未低于对照水平。两组患者每克血红蛋白的血小板相对数量在转流期间及转流后均略有增加,且在鼓泡式氧合器组中这种增加具有显著性。循环中血小板的平均大小仅在鼓泡式氧合器组增加,且仅在术后1天的样本中出现。这些发现表明,在长达2至3小时的心肺转流期间,膜式氧合器在血小板保存方面并无优势。

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