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目的观察库存悬浮红细胞应用血液回收机洗涤处理后预充对婴幼儿体外循环后炎症因子水平的影响。方法选取室间隔缺损择期手术患儿40名,随机分成对照组A(Group A)实验组B(Group B),A组对CPB预充用库存悬浮红细胞不进行任何处理,B组应用血液回收机对库存悬浮红细胞进行洗涤处理后再预充。分别在体外循环开始前(T1)、体外循环结束时(T2)、术后2 h(T3)、术后12 h(T4)、术后24 h(T5)取动脉血标本行TNF-α、IL-6、IL-8、IL-10和C-反应蛋白(CRP)检测,比较2组之间差异。结果 2组患儿的血TNF-α、IL-6、IL-8、IL-10和CRP在T2、T3、T4均呈持续升高趋势并在T5恢复至略高于术前水平;TNF-α、IL-8在术后整个过程实验组均显著低于对照组(P<0.05);IL-6、IL-10在T5实验组和对照组差别无统计学意义(P>0.05);CRP T3至T5显著升高无下降趋势且实验组显著低于对照组(P<0.05)结论血液回收机洗涤预充用库存悬浮红细胞可降低婴幼儿体外循环后机体炎症因子水平,减轻全身炎症反应,促进患儿术后恢复。
Objective To observe the influence of pre-filling on the levels of inflammatory cytokines in infants after cardiopulmonary bypass with suspension of erythrocytes by blood collection machine. Methods Forty infants with ventricular septal defect undergoing elective surgery were randomly divided into two groups: group A (group B), group A (group B), group C (group B) Stock suspension of red blood cells for washing and then pre-filled. The serum levels of TNF-α, TNF-α and TNF-α in blood samples were taken before onset of cardiopulmonary bypass (T 1), end of cardiopulmonary bypass (T 2), at 2 h postoperatively (T3), at 12 h postoperatively (T 4) IL-6, IL-8, IL-10 and C-reactive protein (CRP) were measured to compare the differences between the two groups. Results The levels of TNF-α, IL-6, IL-8, IL-10 and CRP in T2, T3 and T4 of the two groups increased continuously and returned to slightly higher than preoperative levels at T5. TNF- The levels of IL-8 and IL-8 in the experimental group were significantly lower than those in the control group (P <0.05). The levels of IL-6 and IL-10 in the experimental group and the control group were not significantly different (P> 0.05) (P <0.05) Conclusions The blood collection machine can reduce the level of inflammatory cytokines in infants after cardiopulmonary bypass, reduce the systemic inflammatory response and promote Children recover after surgery.