小儿体外循环无血预充临床研究

Cardiopulmonary bypass without blood priming in infants and children

  • 摘要: 目的: 回顾性研究我院小儿体外循环无血预充的情况。方法: 选取我院1996年12月~2002年11月期间年龄≤ 13岁,体重≤ 30kg的体外循环患者970例作为研究对象。1996年12月~1999年11月间4 95例为A组,1999年12月2002年11月间4 75例为B组。B组应用SAFEMINI和SAFEMICRO膜肺及婴幼儿微栓、管道,A组不使用。结果: A组应用血液预充的患者113例(22.8%)高于B组4 2例(8.8%,P<0.01),A组预充总量(933± 239) ml高于B组(5 25± 171) ml (P<0.01)。A组预充血液的患者的年龄、体重均高于B组(P<0.01)。两组患者停机时复查血红蛋白无差异,ICU住院时间和死亡率无差异(P>0.05)。结论: 应用SAFEMINI和SAFEMICO膜肺及婴幼儿微栓、管道减少了体外循环预充总量,有助于实现小儿体外循环的无血预充。

     

    Abstract: Objective: To study the result of cardiopulmonary bypass(CPB)without blood priming in infants and children. Methods: 970 pediatric patients weighing less than 30kg admitted for congenital heart defects were retrospectively studied. They were divided into two groups: 495 of them admitted on Dec.1, 1996 to Nov. 30, 1999 were in group A, while the others admitted from Dec.1, 1999 to Nov. 30, 2002 in group B. Children-special oxygenator SAFEMINI or SAFEMICRO, venous reservoir and circuit were used only in group B, but not in group A. Data were collected including total priming volume, blood transfusion occurrence, and hematocrit before and after the operation. Results: Out of the 495 patients in group A, 113 (22.8%) had used stored blood, while in group B, there were 42(8.8%, P<0.01). The total priming volume in group A was greater than in group B. Group B received significantly less stored blood than group A. The ICU stay and modality showed no difference in the two groups(P>0.05).Conclusions: We think that the children-special SAFEMINI or SAFEMICRO oxygenator, venous reservoir and circuit play a significant role in reducing the total priming volume. All the above are useful for safe and efficient cardiopulmonary bypass.

     

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