【摘要】 目的探讨采用自体肺代替人工氧合器的体外循环技术是否比常规体外循环对肺组织有更好的保护作用。方法12只小猪随机分为实验组和对照组。实验组用自体肺代替人工氧合器,对照组按常规体外循环方法,分别转流135min,主动脉阻断60min,测定实验前、后肺静态顺应性、肺动-静脉氧差,检测灌注液中肿瘤坏死因子(TNF)α、白细胞介素(IL)6变化,测定肺组织湿干比和观察肺病理学改变。结果两组体外循环后的肺静态顺应性均下降、肺动-静脉氧分压差增大,灌注液中TNFα和IL6含量增加,但两组相比,实验组的改变显著轻于对照组。肺组织标本显示,实验组的肺湿干比明显低于对照组,光镜和电镜观察肺损伤程度也较轻。结论自体肺能够耐受非搏动性灌注而代替人工氧合器进行体外循环且可显著减轻因肺的缺血再灌注以及因采用人工氧合器所引起的炎症反应性肺损伤,对肺组织有较好的保护作用。更多还原

【Abstract】 Objective To study whether autologous lung as oxygenator in cardiopulmonary bypass is better than the conventional cardiopulmonary bypass with artificial oxygenator in pulmonary preservation. Methods 12 piglets were randomly divided into two groups with six each. The experimental group underwent bi-ventricular bypass with autologous lung perfusion. While control group underwent conventional cardiopulmonary bypass with artificial oxygenator. The bypass time and aortic cross clamping time were 135 min and 60 min respectively for each animal. The lung static compliance （Cstat）, the alveolus-artery oxygen difference （PA-aO₂）, the TNF-α, IL-6 and wet to dry lung weight ratio （W/D） were measured. Histological and ultra-structural changes of the lung were also observed after bypass. Results After cardiopulmonary bypass, the Cstat decreased, the PA-aO₂ increased and the content of TNF-α increased for both groups, but the changes of experimental group were much less than those of control group. Lower W/D ratio and milder pathophysiological changes in experimental group were also demonstrated. Conclusion Autologous lung can tolerate nonpulsatile perfusion. It can be used as oxygenator in cardiopulmonary bypass to substitute the artificial oxygenator. By this method, the inflammatory lung injury after cardiopulmonary bypass caused by ischemia reperfusion and using non-physiological artificial oxygenator could be lessened.更多还原