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find Author "黄维勤" 2 results
  • 米力农对合并肺动脉高压瓣膜病患者体外循环期间肺氧合功能的影响

    目的 探讨体外循环(CPB)期间米力农对心脏瓣膜病患者肺氧合功能是否具有保护效应及预给药对肺保护作用的影响。 方法 将30例合并肺动脉高压瓣膜病患者,按照米力农的给药方法不同随机分为3组,每组10例。Ⅰ组、Ⅱ组分别于麻醉诱导前、CPB后并行阶段泵入米力农,泵速均为0.5μg/kg·min;对照组给予生理盐水,以相同速度泵入。于麻醉诱导后(T1)、开胸时(T2)、停CPB(T3)、术毕(T4)及术后4h(T5)测定3组的血流动力学和血气指标,计算氧合指数(OI)和肺内动静脉分流率(Qs/Qt)。 结果 3组患者T1时肺动脉收缩压(SPAP)、肺血管阻力(PVR)和Qs/Qt均高于正常,组间比较差异无统计学意义(Pgt;0.05)。与T1比较,T2时各指标差异无统计学意义,在T3、T4、T5后各时点心脏指数(CI)均明显增高(Plt;0.05);PVR、SPAP逐渐降低(Plt;0.05);Ⅰ组停机后OI值较T1增高(Plt;0.05),Qs/Qt降低(Plt;0.05)。在T3、T4、T5时,Ⅰ组的PVR,Qs/Qt和OI与其它两组同期比较差异有统计学意义(Plt;0.05)。 结论 米力农能够改善重症心脏瓣膜病患者CPB期间肺部氧合功能,术前预给药可能有利于发挥肺保护效应。

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
  • Protective effect of autologous platelet separation on blood in surgery for Standford type A aortic dissection: A randomized controlled trial

    Objective To investigate the protective effect of autologous platelet separation on blood in surgery for Standford type A aortic dissection. Methods A total of 180 patients with Standford type A aortic dissection undergoing elective major vascular surgery in our hospital from July 2014 to March 2016 were enrolled. There were 123 males and 57 females with age ranging from 19 to 68 years and weight of 50-85 kg. The patients were randomly divided into two groups. Patients in group A (n=92, 65 males, 27 females, mean age of 45±21 years) received intraoperative autologous blood recovery; while those in group B (n=88, 58 males, 30 females, mean age of 43±24 years) received autologous platelet rich plasma (APRP) and intraoperative autologous blood recovery. The whole process of platelet separation was completed before heparinization. The relevant indicators of blood coagulation function before the induction of anesthesia (T1), before heparinization (T2), immediately postoperatively (T3) and 1 h (T4), 24 h (T5) postoperatively were measured. Cardiopulmonary bypass, aortic cross-clamping time, drainage volume at postoperative 1 h, 24 h and allogeneic blood transfusion volume were recorded. Results The whole blood volume of group B in the platelet separation in emergency was 1 305±110 ml, and collected platelet rich plasma was 275±30 ml, platelet counts (630±220)×109/L, accounting for 25%±5% of platelets of whole blood, and platelet separation time was 32±9 min. Compared with group A, platelet count at postoperative 1 h in group B was significantly higher; drainage volume at postoperative 1 h, 24 h, allogeneic red blood cells, plasma transfusion volume and allogeneic platelet infusion rate decreased significantly (P<0.05). Group B had less postoperative complications (P<0.05). Conclusion Preoperative autologous plateletpheresis combined with intraoperative autologous blood recovery can significantly improve the coagulation function of patients with vascular surgery, and reduce the amount of allogeneic blood transfusion and postoperative bleeding.

    Release date:2017-01-22 10:15 Export PDF Favorites Scan
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