【摘要】 对采用体外循环行心内直视手术的３８例重危病人围术期血液流变学指标及肌组织超微结构变化进行了观测。心肺转流中及术后早期。血液粘度显著降低（Ｐ＜０．０１），红细胞刚性指数增高（Ｐ＜０．０１）；微血管内红细胞变形、聚集。血液稀释、低温、体外循环机械作用及预充液成分等是影响血液流变性的主要因素；调节血液粘度、改善血液流变性状态，对体外循环重危病人术中及术后心肺等脏器的保护至关重要。更多还原

【Abstract】 This article reports the results of the perioperative hemorhcology and muscle tissue ultrastructrre observed in 38 critical patients undergoing open - heart surgery with cardiopulmonary bypass(CPB). The heart runctions(NYHA) of thirty - eihht patients, 17 male and 21 female, 10 to 48 years, were grads Ⅱ to Ⅳ. The surgical procedures included mitral valve replacement in 17 cases, closure of ventriculer septal defect in 6 cases, artrial septal defect in 10 cases, excision of artrial myxoma in 5 cases. The results showed that blood viscosity (ηb) and plasma viscosity(ηp) reduced by 46. 75% and 26. 19% respectively (P < 0. 01) during CPB,the significant difference still remained 24 hours postoperatively; the index of red cell rigidity(IR) increased markedly(P< 0.01) during CPB and 24 hours postoperatively;the findings of muscle tissue ultrastructural changes were deformarion and aggregation of the crythrocytes in the blood capillary. It is suggested that the hemodilution,hypothermia,metabolic acid,the mechanical effect(anomlous shear stress) of CPB and the composition of priming solution are the major factors for influencing perioperative hemorheology in critical patients. To regulate blood viscosity and improve hemorheology are beneficial for protecting the important organs(such as heart, lung) in the critical ill patients.更多还原