2018 年第 3 期 第 13 卷

自主研发的可调节环缩装置对肺动脉血流约束效果的初步实验研究

A preliminary experimental study on the effect of adjustable pulmonary artery banding contraption on pulmonary arterial blood flow

作者：彭博王强蒋显超范凡奕桐

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单位：100037北京，中国医学科学院阜外医院小儿外科中心38病区

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• 摘要：

• 目的    验证自主研发的可调节环缩装置对需肺血流约束作用的肺动脉的环缩效果。方法    20只实验用中华小型猪完全分为对照组和观察组，各10只。对照组手术置入环缩装置，术后不做环缩调整。观察组手术过程中不进行环缩加压，而在术后清醒状态下，在超声监控下逐步环缩，设定环缩压差为30 mmHg（1 mmHg=0.133 kPa），观察血流动力学变化。结果    与对照组相比，观察组在导管注水，环缩装置可产生30~35 mmHg压差，并使血氧饱和度降低到94%左右，在实验动物出现血流动力学剧烈变化时，可通过释放压力做出调整，该装置在缓解压差过大或不足时有效。观察组跨装置肺血流速度快于，压差大于，血氧饱和度低于对照组［（2.47±1.17）m/s比（0.40±0.11）m/s、（30.2±3.4）mmHg比（3.2±1.0）mmHg、（92.0±2.1）%比（100.0±0.0）%］，差异均有统计学意义（均P<0.05）。结论    该环缩装置在控制肺血流方面有效，能够根据需要设定环缩压力。

• Objective    To verify the effect of adjustable pulmonary artery banding contraption on pulmonary arterial blood flow. Methods    Twenty Chinese miniature pigs were randomly divided into control group and observation group, with 10 pigs in each group. After implantation of adjustable pulmonary artery banding contraption, the observation group had progressive ring contraction at pulmonary artery with guidance of ultrasonic monitoring; the differential pressure of ring contraction was 30 mmHg; the control group was not treated by ring contraction. Hemodynamic changes were observed. Results    Differential pressure of ring contraction in observation group could achieve 30-35 mmHg by water injection; blood oxygen saturation was 94%. Transcontraption pulmonary arterial blood flow velocity was significantly faster, differential pressure was significantly higher and blood oxygen saturation was significantly lower in observation group than those in control group［（2.47±1.17）m/s vs （0.40±0.11）m/s, （30.2±3.4）mmHg vs （3.2±1.0）mmHg,（92.0±2.1）% vs （100.0±0.0）%］(P<0.05). Conclusion    The adjustable pulmonary artery banding contraption is effective in controlling pulmonary blood flow.