| At present,with the progress of cardiac surgical technique and the improvement of myocardial protection,the incidence of complications that is associated with cardiac surgery becomes lower and lower, the mortality of cadiac surgery id signifcantly reduced,but lung injury is one of the most common complications of the open-heart surgy under the cardiopulmonary bypass.Now most scholars hold that there are two main types of the mechanism of CPB’lung injury,the first mechanism is the systemic inflammatory response syndrome,it is induced mainly by factors such as the extracorporeal circulation pipe and artificial membrane’s contaction wtih blood,hemodilution,surgical trauma etc.The second mechanism is lung ischemia-reperfusion injury in the process of surgery,therefore more domestic and foreign turn to study that how to reduce the lung injury after open-heart surgery under cardiopulmonary bypass for the lung protection.Now the main measures of lung injury were the drug treatment,leukocyte filter technology, inprovement of extracorporeal circulation(CPB)equipment and technology,changing the lung ventilation way during the extracorporeal,etc.Among them the main drug treatment of lung injury were glucocorticoid,ulinstatin,NO or its precursor,etc.But these studies failed to eliminate the interference of heart disease.The low molecular weight heparin was conducted as anticoagulant drugs,Its anti-inflammatory effect has been become the hot spot of the study of the treatment of sepsis,its’ anti-inflammatory effect was affirmed,but whether the low molecular weight heparin could induced the the CPB’s SIRS,this anti-inflammatory rarely make the news aroud, This topic was proposed by cardiac surgery patients,they were divided into the low molecular weight haparin treatment group(treatment group) and the same amount of normal saline group(control group).Statistical analysis the two group patients index related to inflammation factor and pulmonary function.Objective Discuss and evaluate the effect of low molecular weight heparin in the treatment of CPB’s lung injury. Method the 30 patients who needed heart surgery because of the pure aortic stenosis were seleted as the research Object, these patients were respectively hospitalized In the first affiliated hospital of Guangxi medical university in January 2014 to December 2014, were randomly divided into treatment group and control group, treatment group was among them, 15 cases were treated with the low molecular weight heparin;In the control group,15 cases were treated with the same amount of saline solution.To statistic analysis two groups of patients’ parameters related with inflammation factors and lung function.In the following respective time points,To extract arterial blood from the patients at the six points:T0(predose);T1(before CPB begining);T2(30min after CPB);T3(CPB stop immediately);T4(2h after CPB);T5(6h after CPB),to test the values of the serum inflammatory factors thromboxane B2 and prostacyclin(6-keto-PGF1a) and record the indicators of respiratory function change as the respiratroy index(RI),oxygen index(OI),static compliance of lung(Cst)at the T0,T1,T2,T3,T4 and T5 time points. Result by comparison,there was no statistically significant difference about test between two groups of clinical data and methods(P>0.05).It was no statistical significance between the treatment group with the control group on comparioson of TXB2 and 6-ketoPGF1αbefore CPB(P>0.05).Their values increased significantly at the T2 and T4,the difference was statistically significant(P<0.05).The comparative differences of two groups of cases of respiratory index(RI),oxygen index(OI) and statical compliance of lung(CSt) were no statistical signficance.The values of RI and OI of treatment group were significantlly lower than control group after CPB,but the values of CSt of treatment group were significantly higher than the control group at each point after CPB. Conclusion The low molecular weight had a certain treatment efficacy of the lung injury related to the CPB in the heart surgery. |
PDF Full Text Request