改良二氧化碳（CO2）充溢技术在小儿先天性心脏病手术中防止气体栓塞的安全性和有效性

Safety and Effectiveness of Modified Carbon Dioxide （CO2） Enrichment Technology in Preventing Gas Embolism in Pediatric Congenital Heart Disease Surgery

目的:探讨改良二氧化碳充溢技术运用在小儿先天性心脏病手术中防止气体栓塞的效果及安全性。方法:选取某院2016年3月~2018年1月收治的60例先天性心脏病患儿进行研究,根据入院单双日的顺序将患儿分为观察1组、观察组2组和对照组。观察组实施CO2充溢法,1组为CO210L/min,2组为CO25L/min,对照组则不应用CO2充溢法,比较两组的手术效果。结果:资料统计显示,研究所选取的60例患儿手术均取得成功,且体外循环、主动脉阻断时间及手术时间3项指标比较均无统计学意义(P>0.05);观察组两组主动脉开放10min脑膜中动脉气泡数量均明显低于对照组,且各项数据均有统计学意义(P<0.05);停止CPB前5min,3组脑膜中动脉气泡数量比较无统计学意义(P>0.05);主动脉开放及停止体外循环时,各组PaCO2比较均无明显的统计学意义(P>0.05)。结论:改良二氧化碳充溢技术运用于小儿先天性心脏病手术中能够有效控制气体栓子数量,且效果与气流量呈正比,该方法经对比研究,效果及安全性良好,值得在临床中借鉴并予以推广。

Objective: To investigate the efficacy and safety of modified carbon dioxide enrichment technology in preventing gas embolism in pediatric congenital heart disease surgery. Methods: 60 children with congenital heart disease admitted to a certain hospital from March 2016 to January 2018 were studied. According to the order of admission, the children were divided into observation group 1, observation group 2 and the control group. The observation group carried out the CO2 enrichment method, the group 1 was CO210 L/min, the group 2 was CO25 L/min, and the CO2 enrichment method was not applied to the group. The operation effect of the two groups were compared. Results: The data statistics showed that the 60 cases of children selected in the study achieved successful surgery, and there were no statistical significance in the three indexes of cardiopulmonary bypass, aorta blocking time and operation time(P>0.05). The number of arterial bubbles in the meninges after opening two groups of aorta for 10 min in the observation group was significantly lower than that of the control group, and there were significant differences between the various data(P<0.05);5 min before CPB cessation, no statistical significance was found in the number of arterial bubbles in the meninges of the three groups(P>0.05);When the aorta was opened and the cardiopulmonary bypass was stopped, there was no statistical significance in the comparison of PaCO2 in each group(P>0.05). Conclusion: The modified carbon dioxide enrichment technique can effectively control the number of gas embolus in pediatric congenital heart disease surgery, and the effect is proportional to the gas flow. After compared and studied, the effect and safety of this method are good, and it is worthy to be used for reference and popularized in clinic.