紫绀型与非紫绀型先天性心脏病患儿围手术期输血比较

Comparison of blood transfusion in open-heart surgery on children with cyanoic or acyanotic congenital cardiovascular disease

目的:比较紫绀型与非紫绀型先天性心脏病患儿心内直视修补术围手术期输血量。方法:选取北京儿童医院先天性心脏病体外循环下行心脏直视手术的患儿,根据患儿疾病分为2组:紫绀型先天性心脏病组(法洛氏四联征、完全型肺静脉异位引流、完全型大动脉转位、肺动脉闭锁等)和非紫绀型先天性心脏病组(室间隔缺损、房间隔缺损、动脉导管未闭、主肺动脉间隔缺损、心内膜垫缺损等),分别比较体重7kg以下、10kg以下、20kg以下2组患儿围手术期输注红细胞和血浆的量。结果:紫绀型组患儿平均用红细胞(4.02±2.33)U,非紫绀型组则平均用(3.08±1.07)U,紫绀型组多于非紫绀型组,差异有统计学意义(P<0.01)。血浆用量紫绀型组平均(445.07±155.64)ml,非紫绀型组平均为(298.77±103.97)ml,前组亦显著多于后组,差异有统计学意义(P<0.01)。结论:紫绀型先天性心脏病患儿围手术期用血量多于非紫绀型,尤其是血浆用量更是如此。

Objective：To compare the volume of blood transfusion in children undergoing open-heart surgery with cyanotic or acyanotic congenital cardiovascular diseases.Method：Children with congenital cardiovascular diseases who were admitted in Beijing Children＇s Hospital were divided into two groups：cyanotic group （including tetralogy of fallot TOF,total anomatous pulmonary venous connection TAPVC,complete transposition of the great arteries CTGA,pulmonary atresia PA,） and acyanotic group （including ventricular septal defect VSD,atrial septal defect ASD;patent ductus ateriosus PDA,aorta-pulmonary septal defect APSD,atrioventricular canal AC）.The volumes of red blood cell and fresh frozen plasma used in the children of two groups under 7kg,10kg and 20kg body weight were compared respectively.Result：The children in cyanotic group transfused the average volume of red blood cell（4.02±2.33）units,but in non-cyanotic group it was （3.08±1.07） units.The former was more than the latter statistically（P0.01 ）.Meanwhile （445.07±155.64）ml and （298.77±103.97）ml plasma were transfused into the children of cyanotic group and non-cyanotic group respectively.The volume of plasma used in cyanotic group was significantly higher than that of non-cyanotic group（P0.01）.Conclusion：In the children undergoing open-heart surgery,more red blood cell were used in cyanotic children than that in acyanotic children and so it was with the plasma especially.