高流量深、中度血液稀释体外循环在小儿中的应用

THE USE OF HIGH FLOW CARDIOPULMONARY BYPASS WITH EXTREME OR MEDIUM HAEMODILUTION IN PEDIATRIC SURGERY

本文总结74例采用高流量深、中度血液稀释体外循环的小儿心内直视手术。全组总转流时间45.1±36.51min;主动脉阻断时间28.64±27.45min。所有病例均测定转流中及术后2h血气分析及电解质。结果表明高流量深、中度血液稀释,本外循环在婴幼儿是有益的,但应注意避免过度血液稀释可能的并发症。婴儿和低龄幼儿应以冷冻新鲜血浆和少浆血作为预充液中的胶体成分,胶、晶体液的比值以1∶0.8为宜。围术期综合处理对减轻或避免血液稀释后机体反应以及可能出现的不良影响有重要作用。

From October 1986 to October 1987, open-heart surgery had been, performed in 74 oases of congenital heart disease in our hospital, using high flow oardiopulmonary bypass technique with extreme or medium ha3modilution. In this series, the total bypass time was 45.1±36.51min (x±SD), the aortic clamping time 28.6±27.45 min. Blood gas analysis and electrolyte (K+, Na+, Cl-) determinations were done during the bypass and 2 hours after operation in all oases. Kesults showed that this eardiopulmonary bypass technique was of benifit in infants and small children, but much attention should be paid to avoid aide-effects due to over haemodilution. Fresh plasma and packed cell should be used as the priming colloid in haemodilution for infants and small children. The appropriate ratio of colloid to crystalloid haemodilution was 1:0.8. Comprehensive treatment during the perioperative period is very important to avoid or decrease adverse reactions of the human organism to haemodilution.