| Background: In the process of cardiopulmonary bypass assisted cardiac surgery,due to the joint action of various factors,intraoperative and early postoperative inflammatory reactions occur,resulting in multiple organ dysfunction and other complications,which can lead to death of patients.Several methods have been developed to reduce inflammation reaction during cardiopulmonary bypass,but then only shas a certain effect on some patients.Hemoperfusion（also known as blood hemoadsorption）is mainly used to remove cytokines and other substances that cannot be filtered by existing blood purification technologies,so as to achieve the curative effect of purifying blood.At present,hemoperfusion has been applied in the in vitro blood purification treatment of multiple organ dysfunction syndrome,sepsis,hyperlipidemia,severe acute pancreatitis,COVID-19 and other diseases.Although cardiopulmonary bypass combined with hemoperfusion during cardiac surgery has been reported in domestic and foreign studies,its clinical efficacy remains controversial and needs further study.Objective: To investigate the effect of cardiopulmonary bypass combined with hemoperfusion on inflammatory factors,liver function,kidney function-related indexes and postoperative ventilator use time in patients undergoing cardiac surgery in the early postoperative period.Methods: One hundred and twelve patients in the same group of cardiopulmonary bypass division transfer cardiac surgery in the Department of Cardiac Major Vascular Surgery,The First Affiliated Hospital of Anhui Medical University,were selected from March2021 to February 2022,and randomly divided into conventional cardiopulmonary bypass group and cardiopulmonary bypass combined with hemoperfusion device treatment group,and according to the operation time,they were divided into long time cardiopulmonary bypass group（Group B is the control group and Group D is the treatment group）and short time cardiopulmonary bypass group（Group A is the control group and Group C is the treatment group）.Peripheral venous blood was collected at 24 h before,0 h after and 24 h after surgery,and the levels of inflammatory factors such as interleukin-6,interleukin-8,interleukin-10 and tumor necrosis factor-α in serum,liver function,kidney function and other related indexes and the time of ventilator use after surgery were examined,and the indexes were compared at 24 h before,0 h after and 24 h after surgery using SPSS25.0 software.Result:A total of 112 patients were included in this study,including 27 patients in group A,21 patients in group B,27 patients in group C and 37 patients in group D.Preoperative height,weight,gender,age and other clinical data of patients in group A and group C,group B and group D showed no significant statistical differences.Interleukin-6,interleukin-8,interleukin-10 and tumor necrosis factor-α were significantly higher in all patients at 0h and 24 h postoperatively than before surgery,and liver and kidney functions were significantly impaired than before surgery.The increase of interleukin-6,interleukin-8,interleukin-10 and tumor necrosis factor-α at 0h and 24 h postoperatively was significantly lower than that at 24 h preoperatively in the group with prolonged cardiopulmonary bypass combined with hemoperfusion,and the degree of liver and kidney function impairment was significantly lower than that in the group with prolonged cardiopulmonary bypass,and the postoperative ventilator use time was significantly shortened.The differences were statistically significant（p<0.05）.However,the levels of interleukin-6,interleukin-8,interleukin-10 and tumor necrosis factor-α in the short short time cardiopulmonary bypass combined with hemoperfusion group at 0h and 24 h after surgery were significantly lower than those in the conventional short time cardiopulmonary bypass group at 24 h before surgery,and the degree of liver and kidney function injury was significantly lower than that in the short time cardiopulmonary bypass group,but there was no statistically significant difference（P >0.05）.And only the duration of postoperative ventilator use was significantly lower than that of the group of patients with short duration of conventional cardiopulmonary bypass（P <0.05）.Conclusion: Cardiopulmonary bypass combined with hemoperfusion technique can effectively decrease the level of inflammatory factors in the early postoperative period after prolonged cardiopulmonary bypass direct surgery,improve liver function and kidney function in the early postoperative period in patients with prolonged cardiopulmonary bypass to some extent,and reduce the postoperative ventilator use time in patients with prolonged cardiopulmonary bypass,while the improvement is not obvious in patients with short time cardiopulmonary bypass direct surgery. |
