常温心肺转流在儿童心脏直视术的应用

Application of homoiothermal cardiopulmonary bypass in children undergoing open heart surgery

目的观察常温心肺转流(CPB)对儿童围术期血液循环和呼吸功能的影响。方法先天性心脏病患儿44例,随机分为两组:常温组22例,采用常温CPB;低温组22例,采用常规低温CPB。测定术中、术后相关指标的变化。结果常温组在术中、术后早期体循环阻力明显降低,术中无乳酸产生,术后6 h和48 h氧合指数(OI,PaO2/FiO2)显著高于低温组,肺泡气-动脉血氧分压差[Pa(A-a)O2]显著低于低温组,转流与气管内插管时间明显缩短。结论常温CPB比低温CPB具有更好的组织灌注,有利于术后心肺功能的恢复。

Objective To investigate the effects of homoiothermat cardiopulmonary bypass （CPB） on circulatory and respiratory functions in children undergoing open heart surgery. Methods Forty four children with congenital heart disease were randomly divided into two groups with 22 cases each. The patients in group A were treated with homoiothermal CPB, and those in group B with con ventional hypothermic CPB. Results Systematic circulation resistance was significantly reduced dur ing operation and in the early postoperative stage in group A. Oxygenation index（ODin group A was obviously higher and P（A-a）O2 lower than those in group B at 6 and 48 h after operation. The time of CPB and intubation was shorter obviously in group A than that in group B. Conclusion Tissue perfusion during open heart surgery under homoiothermal CPB is better than that under conventional hypothermic CPB in children, which is beneficial to the recovery of cardiopulmonary function.