先天性心脏病患儿体外循环万汶预充对血浆胶体渗透压的影响

Influence of hydroxyethyl starch HES 130/0.4 on plasma colloid osmotic pressure for cardiopulmonary bypass in children

目的观察先天性心脏病患儿体外循环预充羟乙基淀粉130/0.4(万汶)对血浆胶体渗透压的影响。方法将50例体外循环低温全麻心脏手术患儿随机分为观察(万汶)组和对照组各25例,于体外循环中分别预充万汶400ml和血浆10 ml/kg。观察体外循环(CPB)前、CPB开始后10 min、CPB开始后30 min、CPB结束、术后6h及术后24h血浆胶体渗透压(COP)变化、辅助呼吸时间、术后24小时胸液量和尿量及患儿眼球结膜、眼睑水肿情况。结果与对照组比较,万汶组CPB开始后10、30 min、CPB结束、术后6h COP显著高于对照组(P<0.05);万汶组术后辅助呼吸时间较短,出现眼球结膜、眼睑水肿的比率较低。结论以万汶预充能够较好维持先天性心脏病体外循环患儿血浆胶体渗透压水平。

Objective To investigate the influence of hydroxyethyl starch HES 130/0.4（Voluven） preparation on colloid osmotic pressure for cardiopulmonary bypass in children.Methods 50 cases of open heart surgical children under cardiopulmonary bypass were randomly divided into two groups： patients from Voluven group were infused with 6% Volven（130/0.4）400 ml before cardiopulmonary bypass;patients form the control group were infused with blood plasma 10 ml/kg before cardiopulmonary bypass.Colloid osmotic pressures（COP） at the beginning,10 minutes,30 minutes and the end of CPB and 6 hours and 24 hours after CPB were measured.The supportively ventilative time,chest tube drainage and urine volume after 24 hours were measured.The edema of conjunctiva or eyelid were observed.Results COPs at 10 minutes,30 minutes and the end of CPB and 6 hours after CPB of Volven group were higher than the control group（P0.05）.The supportively ventilative time of Volven group were shorter than the control group and the ratio of the edema of conjunctiva or eyelid was lower than the control group.Conclusion Hydroxyethyl starch infusion may keep the proper COP level of cardiopulmonary bypass in children.