摘要：目的 探讨自体肺体外循环(CPB)与人工肺CPB对肺的影响。方法 选择健康杂种犬16只，体重(15±1)kg，随机分为实验组和对照组。实验组，利用杂种犬自体肺作为氧合器。对照组利用鼓泡肺作为氧合器，两组CPB均进行1h，CPB结束后，通过测量动脉血氧分压；右心房、左心房白细胞记数，并计算其比值；肺动脉压；肺标本病理学检查，了解肺损伤的情况。自体肺组在整个CPB期间连续监测肺动脉压。结果 自体肺组CPB后右心房、左心房白细胞比值、肺动脉压低于人工肺组；动脉血氧分压高于人工肺组，自体肺组在整个CPB过程中，肺动脉压低于20mmHg，且肺动脉压维持平稳。肺标本组织学检查示:自体肺组肺损伤较人工肺组轻。结论 自体肺CPB技术在CPB过程中能提供满意的氧合；而且较人工肺能获得更好的肺保护作用。

    关键词：体外循环；自体肺; 人工肺; 肺动脉压; 氧分压;

    The Comparative Study of The Effect of Autogenous Oxygenator CPB and Artificial Oxygenator CPB on Lungs

    HU Jin-xiao， XIANG Xiao-yong

    Department of Cardiovascular Surgery, the First Affiliated Hospital

    of Chongqing Medical University, Chongqing 400016 China

    Abstract: OBJECTIVE To study the effect of autogenous oxygenator cardiopulmonary bypass(CPB) and artificial oxygenator CPB on lungs. METHODS 16 adult mongrels (weight 15 ± 1kg) were randomly divided into two groups, 8 for Experimental group, in that the dog's own lung was used as oxygenator; 8 for Control group in that the artificial lung(bubble oxygenator) was used as oxygenator. CPB was kept running for 1 hour in both groups. The amount of leukocytes (blood samples from right atrium and left atrium ), and the ratio of leukocyte was calculated, the pulmonary artery pressure, the oxygen pressure were measured at the time points；before-CPB and the 5、30、60、90 minutes after CPB in both groups. Lung biopsies were obtained before and after CPB in both groups for microscopic examination. RESULTS The ratio of leukocyte, pulmonary pressure after CPB were significantly lower in the experimental group than that in the control group. The oxygen pressure after CPB was significantly higher in the experimental group than that in the control group. Lung tissue histologic examination revealed that in Control group there were more obvious intraalveolar hemorrhage leukocyte adhesion and interstitial edema compared with Experimental group.CONCLUSION The autogenous oxygenator CPB technique provides satisfactory oxygenation and better lung protection. ......