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The lung protective effect by zero-balance ultrafiltration in acute type A aortic dissection surgery
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- Author:
- No author available
- Journal Title:
- China Medicine
- Issue:
- 11
- DOI:
- 10.3760/j.issn.1673-4777.2021.11.011
- Key Word:
- 急性A型主动脉夹层;零平衡超滤;体外循环;肺保护
Abstract： 目的 探讨零平衡超滤对急性A型主动脉夹层手术患者的肺保护作用.方法 连续选取2019年1—12月于首都医科大学附属北京安贞医院接受手术治疗的急性A型主动脉夹层患者60例进行前瞻性随机对照研究,采用随机数字表法将患者分为观察组和对照组,各30例.观察组患者术中予零平衡超滤,对照组患者术中予常规超滤,比较2组手术及围术期资料、肺保护作用及预后情况.结果 观察组与对照组体外循环时间、主动脉阻断时间、停循环时间、普通超滤量及手术方式比较差异均无统计学意义(均P>0.05).2组术前乳酸、动脉血氧分压、动脉血氧饱和度、氧合指数差异均无统计学意义(均P>0.05);观察组术中并行阶段(T1)、术后1 h(T3)动脉血氧分压、动脉血氧饱和度、氧合指数均高于对照组[T1时点:(174±82)mmHg(1 mmHg=0.133 kPa)比(130±73)mmHg、(98.5±2.4)％比(94.6±6.7)％、(289±137)mmHg比(216±122)mmHg;T3时点:(156±70)mmHg比(86±17)mmHg、(98.2±1.3)％比(96.0±2.9)％、(249±119)mmHg比(143±32)mmHg],差异均有统计学意义(均P<0.05).观察组术后出现急性肺损伤、急性呼吸窘迫比例均低于对照组,住院天数少于对照组,差异有统计学意义(均P<0.05).结论 急性A型主动脉夹层患者术中联合使用零平衡超滤在围术期肺保护方面效果显著.
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