库存悬浮红细胞经超滤后电解质及生化的改变

Changes of Electrolyte and Biochemical indicators of Stored Packed Red Cells after Ultrafiltration

目的观察体外循环预充的库存悬浮红细胞（悬红）经超滤后电解质及生化指标的变化。方法将作为小婴儿预充的悬红2个单位为1份,共选30份悬红,入选悬红存放日期为513 d。30份悬红超滤前为A组（n=30）,超滤后为B组（n=30）,超滤液为C组。超滤方法：体外循环的动脉、静脉管路钳闭不预充,膜肺及其他部分用500 ml勃脉力预充,加入15 mg肝素及2个单位的悬红,混匀后开始超滤。超滤结束后,将2组悬红及超滤液进行血气、电解质及生化指标的检测。结果A组血K＋及乳酸浓度随存放期延长浓度逐渐增高,其他离子及生化指标均与存放期无关;B组血K＋浓度、乳酸浓度、尿素氮、血糖与A组比较明显降低（P〈0.01）,其他离子与超滤前无明显变化。结论尽管保存期长的悬红血K＋浓度、乳酸浓度及血糖值很高,但经超滤后可降至正常生理范围或接近正常高限,在血源紧张的前提下,保存期长的悬红经超滤后可以安全使用。

OBJECTIVE The purpose of this study is to evaluate the changes of electrolyte and biochemical indicators of stored packed red cells after ultrafiltration.METHODS 30 of 2 units stored blood cells for cardiopulmonary bypass priming were divided into three groups ： pre-ultrafiltration（A）,post-ultrafiltration（B） and ultrafiltration fluid（C）.500ml Multiple Electrolytes Injection（Baxter）,2 units old stored packed red cells and 15mg heparin were primed in oxygenator.The levels of potassium,glucose,lactate and the acid-base balance were mesured in each group.RESULTS There was a linear increase in potassium and lactate levels in packed red blood cell samples with increasing packed red blood cell age in group A.Significant decrease（P〈0.01） of the concentration of potassium,lactate,BUN,glucose in group B compare to group A.CONCLUSION The significantly higher concentration of potassium,lactate and glucose in old stored packed red blood cells may safely used in priming to children undergoing cardiac surgery after ultrafiltratioin.