体外循环质量管理体系在心脏手术中的应用

Use of Cardiopulmonary Bypass Quality Management System in Heart Surgery

目的 探讨心脏手术期间体外循环质量管理的定量评价方法。方法 将可控的生理指标作为体外循环质量目标管理的基础 ,分析体外循环质量变化的规律 ,确定体外循环的质量水平与围手术期恢复之间的关系。结果 体外循环质量管理控制项目得分与住院费用呈负相关 ,R =- 0 .4 4 6 ,P =0 .0 0 1,与呼吸机使用时间及ICU停留时间呈负相关 ,R分别为 - 0 .4 12、- 0 .4 6 3,P分别为 0 .0 4 1、0 .0 2。呼吸机使用时间与ICU停留时间呈正相关 ,R =0 .0 6 ,P =0 .0 0 1。成人得分偏低的项目是血液稀释不足和静脉混合血氧饱和度偏高 ,儿童得分偏低的项目是尿量不足、静脉混合血氧饱和度偏高。

OBJECTIVE To evaluate methods of Cardiopulmonary Bypass (CPB) Quality Mmanagement during heart surgery. METHODS To establish a CPB database and quality targets. The management foundation is based on controlled physiology target, and by analysis of the regularity of CPB quality changes and the definite relationship of between CPB quality level and peri-operative recovery.RESULTS In adults lower score items were due to under hemodilution and high venous blood saturation. In the children low score items were due to insufficient urine output and high venous blood saturation, the correlated relationship between the CPB Quality Management System score and in hospital charge, time of using ventilator use and time of ICU stay was R=-0.046,-0.412, -0.463;P=0.001,0.041,0.02 respectively. The correlated relationship between time of ventilator use and time of ICU stay was R=0.606,P=0.001. CONCLUSION This system could be used to evaluate Cardiopulmonary Bypass Quality Mmanagement during heart surgery.