不同体外循环预充方法对儿童围术期恢复的影响

The Effect of Different Cardiopulmonary Bypass Priming Methods on Childens' Perioperative Recovery

目的 探讨儿童心脏手术中不同预充方法对围术期恢复的影响。方法 复合预充组 30例 ,使用山莨菪碱、地塞米松、甘露醇及减少晶体预充 ,对照组 30例未使用上述药物、不控制晶体预充。应用体外循环质量评价体系定量分析体外循环质量 ,X线胸片软组织比值反映全身含水量的变化 ,X线胸片肺野密度相对值反映肺内含水量的变化。结果 复合预充组体外循环质量评价系统记分、ICU停留时间、呼吸机使用时间、住院时间、总住院费、全身和肺含水量均优于对照组。体外循环质量管理控制项目得分和住院天数呈负相关 ,R =- 0 .4 2 4 ,P =0 .0 2 ;与住院费用呈负相关 ,R =- 0 .4 4 6 ,P =0 .0 0 1 ;体外循环质量管理控制项目得分与尿量呈正相关 ,R =0 .4 6 6 ,P<0 .0 0 1。呼吸机使用时间与住院费用呈正相关 ,R =0 .76 5 ,P <0 .0 0 1。结论 使用山莨菪碱、地塞米松、甘露醇及减少晶体预充的复合预充方法 ,与对照组相比明显改善围术期的恢复。

OBJECTIVE To investigate the the effect of different priming methods on the cardiopulmonary bypass(CPB) quality change and perioperative recovery. METHODS Patients were divided into two groups - compound and control - with 30 patients in each group. A CPB quality evaluation system was used.RESULTS CPB quality management system score, ICU time, ventilator eime, hospital stay and total hospitalization costs differed notably in the different priming groups. There was a negative correlation between Cardiopulmonary Bypass quality management system score and in hospital time, R=-0.424,P=0.02, Negative correlation between Cardiopulmonary Bypass quality management system score and in hospital cost R=-0.446,P=0.001. Positive correlation between urine outcome and Cardiopulmonary Bypass quality management system score R=0.466, P<0.001 and positive correlation between ventilator time and total hospitalization costs R=0.765,P<0.001.CONCLUSION Different of primes with Anisodamine,Dexamethasone and Mannitol can improve peri-operative recovery.