体重10kg以下婴幼儿先心病体外循环分析

Study of extracorporeal circulation in infant patients less than 10kg body weight

目的:分析体重在10 kg以下危重先天性心脏病小婴儿体外循环(ECC)方法。方法:对临床106例体重在10 kg以下危重先天性心脏病小婴儿进行了ECC下的外科矫治术,ECC分为低温停跳组(Ⅰ)和常温不停跳组(Ⅱ);术中超滤组(Ⅲ)与非超滤组(Ⅳ)。结果:与停跳组(Ⅰ)相比,不停跳组(Ⅱ)ECC时间明显缩短(P<0.05),温度显著提高(P<0.001),总液体量显著减少(P<0.05);与非超滤组(Ⅳ)比,超滤组(Ⅲ)血液稀释度显著减小(P<0.001),稀释后HCT显著提高(P<0.001),术后呼吸极辅助时间明显缩短(P<0.05),胸腔引流量显著减少(P<0.05)。结论:小婴儿手术中减少ECC预充量,选择合适的转流方法,积极超滤可取得良好的效果。

Objective： Research of extraeorporeal circulation of infant patients less than 10kg body weight. Methods ：106 eases were divided to four groups. Group Ⅰ （ n = 77 ） were performed ECC with moderate hypothermia, Group Ⅱ （ n = 29 ） were performed ECC with normal thermia beating heart. Group Ⅲ （ n = 67） were used ultrafiltration and Groupiv （ n = 39） were not used ultrafihration during ECC. Results：total priming volume in group Ⅱ was less than it in group Ⅰ （P 〈 0.05 ） , ECC time in group Ⅱ was shorter than it in group Ⅰ （P ,： 0.05 ）. the intubation time in group Ⅲ was shorter than it in group Ⅳ （ P 〈 0.05 ）, the volume of drainage in group Ⅲ was lower than it in group Ⅳ （ P 〈 0.05 ）, the hemodilution in group Ⅲ was lower than it in group Ⅳ （P 〈 0.001 ） and HCT in group Ⅲ was higher than it in group Ⅳ （ P 〈 0.001 ）. Condusion： Low priming volume, selecting the best ECC method and using concentrator can get good results in infant patients.