改良超滤技术的改进及其在儿童体外循环中的应用

USAGE OF IMPROVED MODIFIED ULTRAFILTRATION IN PEDIATRIC CARDIAC OPERATION WITH CARDIOPULMONARY BYPASS

目的将改良超滤技术进行改进并应用于儿童体外循环 ,评价其超滤效果和节约用血作用。方法 32例接受室间隔缺损修补术的患儿随机分为两组 ,实验组 2 0例 ,采用改进后的改良超滤技术 ;对照组 12例 ,应用改良超滤技术。观察两组患者的超滤液总量和不同时段红细胞压积 (hematocrit,HCT)变化 ,术后出血量和围手术期用血量 ,术后血小板计数、心肌酶谱、呼吸机使用时间、ICU驻留时间、平均住院日等指标。结果实验组超滤液总量增加更明显 ,超滤结束后HCT提高 ;术后出血减少 ,围手术期用血量减少 ;两组术后血小板计数、心肌酶谱、呼吸机使用时间、ICU驻留时间、平均住院日等指标无显著性差异。结论改良超滤技术经改进后超滤效果改善 ;患者术后出血量和围手术期用血量减少 ;可安全应用于临床。

ObjectiveTo improve the technique of modified ultrafiltration and to evaluate the effects of the improved modified ultrafiltration on ultrafiltration and postoperative blood-saving.Methods32 patients underwent surgical correction for ventricular septal defect using cardiopulmonary bypass(CPB), were randomly divided into two groups, experimental group (20 case),with improved modified ultrafiltration in CPB, control group (12 case), with modified ultrafiltration in CPB. The total volume of ultrafiltration, hematocrit(HCT) at specific intervals and transfusion requirement of perioperation, blood loss of postoperation, platelet counts, myocardial enzymes, duration of ventilator support, intensive cure unit(ICU) stay and hospital stay were observed in two groups.ResultsNo significant different were observed between the experimental and control group in platelet, myocardial enzymes, the time of ventilator support, ICU stay and hospital stay. But the total volume of ultrafiltration and HCT was significantly increase, Meanwhile the postoperative blood loss and perioperative transfusion requirement were decreased in experiment group compare to that of the control group.ConclusionThe improved modified ultrafiltration was safe and efficient method for decrease of post operation blood loss and transfusion requirement in pediatric cardiac operation with CPB.