复杂先天性心脏病婴儿使用库存血的安全性

Complex congenital heart disease infant use countermeasures of banked blood

目的 探讨复杂先天性心脏病婴儿临床输注库存去白红细胞悬液的对策、安全性.方法 从2010年7月至2015年7月56例患有复杂先天性心脏病的婴儿在围手术期输注了库存去白红细胞悬液,男性患儿32例,女性患儿24例,年龄1～180 d,平均年龄90d,体重2.2～9.2（5.7±3.5）kg.病种包括：法洛四联症、大动脉转位、完全型心内膜垫缺损、主动脉弓中断、单心室、肺动脉闭锁等.术中及术后早期输注库存去白红细胞悬液,一律应用血液回收机（CS）去除乳酸等对机体产生不良后果的有害物质,经过体外循环术后经静脉输入.结果 经过预处理库存血,减少输注库存血的量,明显减少了术后早期并发症,56例患儿未出现因输血产生的相关并发症,术后早期结果令人满意.其中2例死于肺部感染,1例循环衰竭死亡,3例较长时间应用呼吸机,均与输血无明显相关.56例患儿术中及术后早期均输注库存去白红细胞悬液.结论 临床输注库存去白红细胞悬液对复杂先天性心脏病婴儿均有不同程度的影响,经过预处理库存血和减少输血量会明显降低风险.

Objective To explore the complex congenital heart disease infant clinical infusion inventory , security, white and red blood cell suspension. Methods Observation from July 2010 to July 2015, 56 cases of infants and infant with complex congenital heart disease, the perioperative clinical infusion of inventory to the clinical analysis of white and red blood cell suspension, male children with 32 cases, 24 cases of female children, aged 1-180 days, the average age of 90 days, weight 2.2-2.2（5.7±3.5）kg. Diseases include： tetralogy of fallot, aorta transposition, core lining cushion defect completely and interruption of aortic arch, single ventricle, pulmonary atresia, etc. Intraoperative and postoperative early input infusion inventory suspension without white and red blood cell, uniform application of blood recycling machine （CS） to remove lactic add and other adverse consequences for the body of harmful substances, and after extracorporeal circulation the suspensiong was infused intravenous postoperation. Results After pretreatment with banked blood and reduce the amount of transfusion of banked blood, early post-operational complications were significantly reduced, 56 cases did not appear the blood transfusion related complications, early postoperative result was satisfactory. Among them, 2 cases died of lung infection, 1 case of circulatory failure death, 3 cases of application of breathing machine for a long time, has no obvious associated with blood transfusion. 56 cases were all infused inventory to white and red blood cell suspension intraoperation and early postoperation. Conclusion Clinical infusion inventory to white and red blood cell suspension for complex congenital heart disease of infants and young children has some extent influence and de- crease blood transfusion can significantly reduce the risk.