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目的探讨高流量改良超滤的临床应用效果及其对炎症反应的影响。方法40例先天性心脏病患者用随机数字表法分为两组,常规改良超滤(CMUF)组和高流量改良超滤(HMUF)组,每组20例。观察超滤时间、滤液量、红细胞压积(HCT)和循环指标变化,并检测肿瘤坏死因子和白细胞介素6的浓度。结果40例患者均顺利完成手术,术毕HMUF组超滤时间(7.83±0.75min)短于CMUF组(13.86±1.95min,P<0.01),HMUF组滤出液量(440.00±91.86ml)多于CMUF组(372.22±56.52ml,P<0.01)。两组HCT、循环指标和术后炎症因子浓度的变化均无统计学意义。结论HMUF用于小儿体外循环后安全有效,且可以明显缩短超滤时间。
Objective To investigate the clinical application of modified high-flow ultrafiltration and its effect on inflammatory response. Methods Forty patients with congenital heart disease were randomly divided into two groups: conventional modified ultrafiltration (CMUF) group and high-flow modified ultrafiltration (HMUF) group, 20 cases in each group. The ultrafiltration time, filtrate volume, hematocrit (HCT) and circulatory indexes were observed. The concentrations of tumor necrosis factor and interleukin-6 were detected. Results All the 40 patients completed the operation successfully. The ultrafiltration time of HMUF group (7.83 ± 0.75min) was shorter than that of CMUF group (13.86 ± 1.95min, P <0.01) and that of HMUF group (440.00 ± 91.86ml) In the CMUF group (372.22 ± 56.52 ml, P <0.01). There was no significant difference in HCT, circulatory index and postoperative inflammatory cytokine concentration between the two groups. Conclusion HMUF is safe and effective for pediatric cardiopulmonary bypass, and can significantly shorten the ultrafiltration time.