婴幼儿先心病的体外循环研究

王加利; 李佳春; 高长青

婴幼儿先心病的体外循环研究

Study of cardiopulmonary bypass in 115 pediatric patients

摘要

摘要: 目的：婴幼儿心内直视手术体外循环的研究。方法：临床115例婴幼儿分为体外循环管道不定型（A组）和体外循环管道定型（B组）两组。A组应用进口膜肺35例（57%），鼓泡式氧合器26例（43%），体外循环管道是临时改装。B组应用进口膜肺49例（91%），鼓泡式氧合器5例（9%），体外循环管道选择配置成型的婴幼儿管道，直径6mm，长度100cm。结果：两组患儿的年龄、体重无统计学差异（P＞0.01）。B组与A组相比，体外循环中晶体预充量由（516±172）ml减少至（400±109）ml，差异性显著（P＜0.01）。总液量由（933±239）ml减少至（625±171）ml，差异性显著（P＜0.01）。全血预充量由（414±183）ml减少至（87±106）ml，差异性显著（P＜0.01）。两组稀释度无统计学差异（ P ＞0.01）。术后呼吸机辅助时间由（24.4±23.9）h缩短至（13.2±9.1）h，差异性显著（P＜0.01）。ICU时间由（2.8±1.5）d缩短至（1.6±0.9）d，差异性显著（P＜0.01）。全组115例死亡3例（2.6%）。结论：选用优质婴幼儿膜肺，规范体外循环管道，总预充量控制在500ml以下，保持较高的胶体渗透压是婴幼儿体外循环的关键。

Abstract: Objective：Research of cardiopulmonary bypass of pediatric patients with congenital heart disease. Methods：115cases were divided to two groups.group A（n=61） were performed CPB with uncertain tubing system and group B（n=54） with certain tubing system.Group A and B were both primed with Ring's and colloid.Results：There were no difference in age，body weight between group A and B.The crystalloid prime volume in group B was less than it in group A（P＜0.01）.Also in group B，the total volume and the blood prime volume were much less than those in group A （P＜0.01）.Beside these，The intubation time and ICU days for patients in group B were shorter than in group A （P＜0.01）．Conclusion：It plays an very important roll in CPB technique that the certain tubing system，low prime volume and good membrane oxygenator in pediatric patients.

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