体外循环改良超滤在心脏瓣膜手术中应用的临床研究

摘要

目的：研究体外循环改良超滤在心脏瓣膜手术中应用的临床价值。方法选择2014年1月至2016年6月行瓣膜置换及瓣膜成形手术病例82例。根据性别、年龄、体重、射血分数、心功能分级、心胸比、阻断时间进行相似配对，按随机化的原则将其分为实验组和对照组。实验组采用改良超滤技术，对照组采用传统的超滤技术。最后于术后统计术后24 h 及48 h 胸液引流量、临床用血量、ICU 停留时间及住院时间。结果①术前以及超滤前两组红细胞比容（Hct）值相比，差异无显著性（ P ＞0.05），而超滤之后实验组的 Hct 值显著高于对照组（ P 0. 05),but after ultrafiltration Hct value in modified ultrafiltration group was significantly higher than ordinary super filter group,the difference was statistically significant( P < 0. 05). ②modified ultrafiltration group 24 hours after pleural fluid drainage,48 hours after pleural fluid drainage, the amount of blood for clinical use,ICU stay time and hospital stay were significantly lower than those in ordinary ultrafiltration group,the differ-ence was statistically significant( P < 0. 05). Conclusion The modified ultrafiltration may concentrate blood in a short time,improve Hct,im-prove heart and lung function,while reduce the use of banked blood,ICU stay and hospital stay time. The postoperative recovery is better than or-dinary ultrafiltration,and is worthy clinical promoting clinic applications.