10公斤以下先天性心脏病患儿围术期减少用血

Blood Saving Technique in Open heart Surgery on Children under 10 Kilogram of Weight

目的 探讨婴幼儿先天性心脏病手术减少围术期用血量的体外循环方法。方法 将１０ｋｇ 以下先天性心脏病手术患儿９２ 例分为实验组和对照组，实验组使用预充量小的氧合器，并采用改良超滤法。 结果 同对照组相比，实验组可以将体外循环预充所用的少浆血和血浆用量分别从３４３ ±７３ｍｌ 和２８５ ±１３８ｍｌ 降低到２２０ ±７７ｍｌ 和１６２ ±７２ｍｌ，还可以把术后少浆血用量从３５６ ±１４０ｍｌ 减少到２７５ ±１２８ｍｌ。 结论 体外循环中要采用综合性措施减少围术期用血量，应尽量减少预充量，并进行血液浓缩；同时还要减少出血，加强止血；减少血液破坏，才能最大限度的减少用血量。

Objective To summarize the clinical experience of blood saving technique employed in open heart surgery on children under 10kg of weight. Methods Ninety two young children with congenital heart disease were divided into two groups, study and control groups. The membrane oxygenator, which was primed less volume, and modified ultrafiltration, which can concentrate the blood after cardiopulmonary bypass (CPB), were used in study group. Results Compared to control group, much less packed red blood cells and free frozen plasma, decreased from 343±73ml, 285±138ml to 220±77ml, 162±72ml, respectively, were used in study group during CPB. And the volume of packed red blood cells, which were used after CPB, was decreased from 356±140ml to 275±128ml in study group. Conclusion During CPB, the synthetical management, including decreasing priming volume, using modified ultrafiltration, decreasing blood loss, stanching bleeding, ameliorating blood damage and so on, should be used to save blood.