婴幼儿体外循环心脏手术少用血的探讨

Clinical Application of Blood Saving Techniques in Open Heart Surgery on Infants

为探讨深度血液稀释及剩余机血回输在婴幼儿心脏手术应用的安全性。选择２０例婴幼儿室间隔缺损修补术者，随机均分为对照组（Ａ组）和观察组（Ｂ组）。Ａ组采用中度血液稀释（ＨＣＴ０．２０～０．２５），体外循环结束后不回输剩余机血；Ｂ组应用深度血液稀释（ＨＣＴ０．１５～０．２０）和剩余机血回输方法。结果Ｂ组围术期异体库血用量较Ａ组减少６０％，病儿全部顺利康复。作者认为，深度血液稀释及机血回输是减少体外循环心脏手术库血用量切实有效的方法，只要加强围术期综合管理，对婴幼儿也是安全可行的。

Aim:This study was undertaken to evaluate the effects of profound hemodilution for cardioplumonary bypass (CPB) and transfusion of residual oxygenator blood in infants during open heart surgery.Method:Twenty infants with ventricular septal defects underwent surgical repair under CPB.Patients were divided into two groups.In group A (n=10,control group),moderate hemodilution (HCT 20-25%) was used but without transfusion of residual oxygenator blood.In group B (n=10,observation group),profound hemodilution (HCT 15-20%) and transfusion of residual oxygenator blood were applied.Result:During perioperative period,the amount of transfusion of homologous blood was 60% less in group B when compared to group A.All patients in group B was recovered smoothly.Conclusion: Profound hemodilution for CPB and transfusion of residual oxygenator blood are safe and effective methods for saving homologous blood transfusion in infants.