The Comparison Of Domestic And Impotred Membrane Oxygenators Used During Heart Valve Replacement Operation

Heart valve disease is a common form of heart disease, among themwith rheumatic fever caused by valve damage is the most common,seriously affects life quality of patients. Heart valve replacement isone of the important methods for the treatment of heart valvedisease. During cardiac valvular surgery must be blocked in theprocess of circulation, provide bloodless surgical field for surgery,heart operation, so must apply extracorporeal circulation technique.Oxygenator is important component of extracorporeal circulationequipment, at present, heart valve replacement in the application ofmembrane oxygenator is not within the scope of coverage, as theprice of imported membrane oxygenator is relatively expensive, isabout double the domestic oxygenator, increased the economicburden of patients. Research in heart valve replacement surgeryimport and domestic oxygenator application effect, analysis ofwhether there are significant differences, both for the patients toreduce the economic burden and promote domestic oxygenationapparatus has important application significance. Objective：In patients with cardiac valve replacement operation, during theoperation two kinds of membrane oxygenator is applied in CPB.According to data analysis of evaluation index, the application effect oftwo kinds of membrane oxygenator during heart valve replacementoperation provides the basis for heart valve replacement operation aswell as the choice of membrane oxygenator in the operation of morecomplex heart.Methods：From October2012to August2013in a Jilin Province tertiary levelhospital, cardiac surgery department heart valve replacement surgerywere performed in patients was divided into G&J categories. G class isusing Xi’an Xijing Medical Supplies Limited production healthmembrane oxygenator in patients with a total of35cases, J class is usingItalian DIDECO Limited production DIDECO membrane oxygenator inpatients with a total of45cases. Informed consent by the patient, byusing simple random sampling method from the G and J category,patients were randomly selected into A&B groups of20in each.‘A’group of patients is using Xian Xi Jian membrane oxygenator,‘B’ groupof patients is using imported Italian DIDECO membrane oxygenator,with20patients in each group. Two groups of patients duringcardiopulmonary bypass, before the start of surgery,30min after the start of surgery, end of surgery,2hours after surgery,24h, five timepoints to take blood, determination of interleukin-6(IL-6), tumornecrosis factor-a (TNF-6) level; simultaneous determination of the twogroups were T1, T2, T3pulse blood oxygen partial pressure (PaO2),partial pressure of carbon dioxide (PaCO2), pH levels; and T1, T3pointin time recovery of blood and urine vein determination of blood andurine hemoglobin content.Results：1. Two groups of patients with pulse blood oxygen partialpressure(PaO2) had no significant difference;2Two groups of patients with pH had no significant difference;3. Two groups of patients with partial pressure of carbon dioxide(PaCO2) had no significant difference;4. After operation in the two groups, blood, urine free hemoglobincontent were no significant differences between the two groups;5. Two groups of patients with serum IL-6TNF-a levels were nosignificant differences between the two groups;6. Patients in the two groups of cooling and rewarming time in theoperation process, as well as in the intraoperative urine volume, complex jumps (defibrillation, automatic), and no significant differences werefound in the comparison of the intubation time;7. Two groups of patients with operation process oxygenator was nofault.Conclusion：By data analysis, this study confirmed that domestic membraneoxygenator performance has reached the international similar productslevel, because its price is far lower than the imports of similar products,in the heart valve replacement domestic oxygenator can reduce theeconomic burden of patients.