CAJ | 학술논문

目的探讨用气动隔膜泵施行搏动体外循环的可行性,并观察该装置对犬肝肾功能的影响.方法利用气动驱动装置、气动隔膜泵、膜肺及体外循环管道建立搏动体外循环回路,连续运转3d后检测搏动体外循环装置的稳定性及测定相关参数；并将20条成年健康杂种犬随机分为实验组(n=10)和对照组(n=l0),实验组施行气动隔膜泵搏动体外循环,对照组施行滚压泵平流体外循环,连续转机6h,比较两组犬肝、肾功能及细胞结构变化.结果气动隔膜泵搏动体外循环装置性能稳定,聚氨酯隔膜能耐受高强度连续工作,影响搏动灌注效果的因素包括驱动的正负压力、搏动频率及占空比.两组犬转机后6h,尿素氮(BUN)、肌酐(Cr)、门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)较转机前明显升高(P＜0.01),实验组BUN(t=1.622,P＜0.01)、Cr(t=1.599,P ＜0.01)、AST(t=1.970,P＜0.05)、ALT(t=1.363,P＜ 0.05)升高水平明显低于对照组(P＜0.05).结论气动隔膜泵的设计符合体外循环原理；气动隔膜泵搏动体外循环方式是可行的,在较长时间的体外循环过程中,其对重要脏器功能的保护作用优于平流体外循环.
목적 탐토용기동격막빙시행박동체외순배적가행성,병관찰해장치대견간신공능적영향.방법 이용기동구동장치、기동격막빙、막폐급체외순배관도건립박동체외순배회로,련속운전3d후검측박동체외순배장치적은정성급측정상관삼수；병장20조성년건강잡충견수궤분위실험조(n=10)화대조조(n=l0),실험조시행기동격막빙박동체외순배,대조조시행곤압빙평류체외순배,련속전궤6h,비교량조견간、신공능급세포결구변화.결과 기동격막빙박동체외순배장치성능은정,취안지격막능내수고강도련속공작,영향박동관주효과적인소포괄구동적정부압력、박동빈솔급점공비.량조견전궤후6h,뇨소담(BUN)、기항(Cr)、문동안산안기전이매(AST)、병안산안기전이매(ALT)교전궤전명현승고(P＜0.01),실험조BUN(t=1.622,P＜0.01)、Cr(t=1.599,P ＜0.01)、AST(t=1.970,P＜0.05)、ALT(t=1.363,P＜ 0.05)승고수평명현저우대조조(P＜0.05).결론 기동격막빙적설계부합체외순배원리；기동격막빙박동체외순배방식시가행적,재교장시간적체외순배과정중,기대중요장기공능적보호작용우우평류체외순배.
Objective To verify the feasibility of pneumatic pump in throb perfusion dunng cardiopulmonary bypass,and observe the influence of the experimental apparatus of kidney and liver function of dogs.Methods Extracorporeal circulation circuits were established by using pneumatic drive device,pneumatic diaphragm pumps,membrane lung and extracorporeal circulation piping,run continuously for 3 days.The stability and relevant parameters of the throb cardiac extracorporeal circulation device were detected.Twenty adult healthy hybrid dogs were randomly divided into test group (n =10) and control group (n =10).The dogs in test group were subjected to the pneumatic diaphragm pump throb extracorporeal circulation,and those in control group to roller pump advectional extracorporeal circulation,the device was run continuously for 6 h,and the function and structural changes of the liver and kidney were observed and compared.Results The performance of pneumatic diaphragm pump throb extracorporeal circulation device was stable,and polyurethane diaphragm could tolerate high strength work continuously.Influencing factors of throb perfusion effect included drive negative pressure,throb frequency,dutyfactor.The blood urea nitrogen (BUN),creatinine (CR),aspartate aminotransferase (AST),alanine transaminase (ALT) in two groups were obviously increased (P ＜0.01 ) as compared with preoperation.After device running for 6 h,the increased levels in BUN ( t =1.622,P ＜ 0.01 ),Cr ( t =1.599,P ＜ 0.01 ),AST ( t =1.970,P ＜ 0.05 ),ALT ( t =1.363,P ＜ 0.05 ) in test group were obviously lower than those in control group (P ＜ 0.05).Conclusion Pneumatic diaphragm pump design meets extracorporeal circulation principle.Pneumatic diaphragm pump throb extracorporeal circulation mode is feasible.The protection to the important viscera function of the throb perfusion is better than advectional extracorporeal circulation during the relatively long time of extracorporeal circulation process.