改良超滤在婴幼儿体外循环心脏手术中的应用

Modified Ultrafiltration for Paediatric Cardiac Surgery after Cardiopulmonary Bypass

目的 观察改良超滤技术对婴幼儿体外循环心脏手术的影响。 方法 自 2 0 0 3年 9月～ 2 0 0 4年 4月 ,15例行先天性心脏病手术治疗的婴幼儿 ,在体外循环转流停止后采用TerumoHc - 0 5超滤器行改良超滤。 结果 l5例患儿均存活 ,无任何超滤相关并发症。超滤时间 (12 .6± 3.1)min ,超滤液量 (2 4 2 .6± 10 9.3)ml。转流中HCT (0 .2 3± 0 .0 4 )L/L ,停机时HCT (0 .2 4± 0 .0 2 )L/L ,超滤结束时HCT (0 .31± 0 .0 3)L/L。 结论 婴幼儿体外循环心脏手术中采用改良超滤能在短时间内有效滤除体内多余水分 ,有效减轻心肺脑等脏器水肿 。

Objective To observe the effect of the modified ultrafiltration after completion of cardiopulmonary bypass (CPB) during open-heart surgery in infants. Method From September 2003 to April 2004, 15 infants with congenital heart diseases underwent open-heart surgery. Durging the operation modified ultrafiltration were carried out after CPB. Result All infants survived and no complications associated the modified ultrafiltration occurred. The average modified ultrafiltration time after termination of CPB was 12.6±3.1 min (range 35～219 min), the mean filtration fluid volume was 242.5±109.3 ml (range 50～350 ml). After 10 to 15 minutes of modified ultrafiltration, the hematocrit increased to 0.31±0.03L/L from 0.24±0.02 L/L. Conclusion The modified ultrafiltration can effectively concentrate the blood in a short time after CPB, attenuate the heart and lung edema and improve recovery early.