The Effect Of Add Ultraviolet Irradiation Of Blood Oxygenation In Cardiac Valve Replacement Surgery

PartⅠResearch on the effect of add ultraviolet irradiation of blood oxygenation on erythrocyte lipid peroxidation, erythrocyte immune adhesion function, inflammatory response during cardiopulmonary bypass priming solution in cardiac valve replacementObjective:To explore the effect of add ultraviolet irradiation of blood oxygenation on erythrocyte lipid peroxidation, erythrocyte immune adhesion function, inflammatory response during cardiopulmonary bypass priming solution in cardiac valve replacement. Methods:48 patients undergoing routine cardiopulmonary bypass cardiac valve replacement surgery were randomly divided into experimental group (24 cases) and control group (24 cases), the experimental group in systemic blood after heparin 10ml/kg through the subclavian vein by weight or use of stored blood cells in blood line After UV irradiation and oxygenation to join pre-filled, the control group with normal saline, These two groups the same as other components of the priming solution, the other dealing with the same 2 groups. To observe the lipid peroxidation of the red blood cell,2 groups were, respectively, after induction of anesthesia, turning 30min, open aortic 30min, collected on day 1 after radial artery blood plasma lipid peroxide (PLPO), red blood cell lipid oxide (ELPO) concentrations and erythrocyte superoxide dismutase (ESOD) activity. To observe the immune adhesion function of red blood cells,2 groups were the induction of anesthesia, after turning 30 min, after the first 1,7 days peripheral blood red cell C3b receptor rosette rate determination (RC3bRR,%) and RBC immune complex rosette rate (RICRR,%). Inflammatory reaction to the situation observed in both groups were in the induction of anesthesia, cardiopulmonary bypass at the end, after 12,24 h time points were collected 4 the radial artery, measured IL-6, interleukin 8, interleukin 10 and tumor necrosis factor a; monitoring the use of postoperative mechanical ventilation time and Intensive Care Division 0,12,24 h back to when the radial arterial blood gas analysis, calculated alveolar arterial oxygen difference. Results:PLPO, ELPO concentration significantly increased after cardiopulmonary bypass, ESOD activity increased after open aortic 30min then decreased (P <0.05) in both groups.PLPO, ELPO level in the experimental group lower than that in the control group at each time point after the beginning of cardiopulmonary bypass. Compared with the control group, ESOD level of the treatment group at each time point after the aortic opening were higher (P<0.05). The RC3bRR, RICRR content in transit 30 min,1,7 day after operation were lower than after induction of anesthesia, Its content 7 days after the operation has not yet recovered to the level of anesthesia induction, Its content in treatment group decreased more significantly (P<0.05); MDA content in the treatment group was lower compared with the control group, in opening the ascending aorta (P< 0.05) contrary with the contention of SOD. (P< 0.05).After induction of anesthesia, patients were observed of the difference was not statistically significant (P> 0.05),.The contention of IL-6, IL-8, IL-10 and tumor necrosis factor-αwere Increased at the end of CPB and 12,24 h after surgery compared with the induction of anesthesia. After 24 h was still higher than normal levels. (P< 0.05); UBIO group of Interleukin-8, tumor necrosis factor-αin the rate of increase at each time point were less than the control group. The levels of interleukin-10 were higher than which in Control groups,but the two groups of IL-6 levels showed no significant(P> 0.05).Conclusion:Adding ultraviolet blood irradiation and oxygenation during cardiopulmonary bypass priming solution reduces heart valve replacement in the red blood cell lipid peroxidation and red cell immune adherence function and inflammatory responsePart 2 Myocardial protection of ultraviolet blood irradiation and oxygenation in elderly patients with the first infusion of artificial biological heart valve replacement surgeryObjective:To explore the effect of myocardial protection of ultraviolet blood irradiation and oxygenation in elderly patients with the first infusion of artificial biological heart valve replacement surgery. Methods:46 elderly patients with cardiopulmonary bypass valve replacement were divided into treatment group (23 cases) and control group (23 cases). Treatment group through the subclavian vein after anesthesia 10ml/kg weight blood line by ultraviolet irradiation and oxygenation (with input by another saline intravenously before operation calculated that during CPB hemoglobin less than 70g/L who instead of using banked blood for autologous ultraviolet blood irradiation and oxygenation) or after aortic cross-clamping, the UBIO as a component of cardioplegia antegrade coronary perfusion for the first time, after the conventional 4:1 in cold blood every 30min/crystal perfusion; control group for the first time antegrade coronary perfusion using cold blood without UBIO 4:1/crystal, the other dealing with the treatment group. The ascending aorta before aortic opening of 5min, 10min from the coronary sinus blood 2ml, superoxide dismutase, malondialdehyde; in the ascending aorta before occlusion and stopped after cardiopulmonary bypass 424,48 h blood was collected from the center of 2ml of static determination of creatine kinase MB and troponin I levels. Results:After aortic declamping, the treatment group serum malondialdehyde in coronary sinus levels lower than the control group, SOD activity was higher (P<0.05); treatment group after 4h to 48h of serum muscle acid muscle isozyme, troponin I levels were significantly lower than the control group (P <0.05) Conclusion:to add ultraviolet irradiation and oxygenation of blood priming solution of cardiopulmonary bypass with cardiac valve surgery to reduce red blood cell lipid peroxidation in patients on cardiopulmonary bypass patients undergoing red cell immune adherence function in the protection to a certain extent, reduce the artificial mechanical valve replacement during cardiopulmonary bypass on cytokine levels in patients, reducing the body's inflammatory response.