羟乙基淀粉预充液在小儿先天性心脏病体外循环中的应用研究

Application of hydroxyethyl starch Precharge solution in cardiopulmonary bypass of congenital heart disease in children

目的探索羟乙基淀粉预充液在小儿先天性心脏病体外循环CPB中的应用。方法对60例先天性心脏病心内直视体外循环手术患儿随机分为羟乙基淀粉组(实验组)和血制品组(对照组),每组30例,观察CPB术前,术后红细胞压积HCT,血浆胶体压,尿液微量蛋白U-Mal,肿瘤坏死因子TNT-ɑ,肝肾功能等多项指标的变化。结果CPB开始前实验组与对照组数据无明显差异(P>0.05),CPB术后HCT,总蛋白指标均有下降,U-Mal,TNT-ɑ等损伤相关指标均有不同幅度上升,肝肾功能无显著差别,两组HCT,血浆总蛋白,肝肾功能,尿液微量蛋白U-Mal,肿瘤坏死因子TNT-ɑ等多项指标在CPB前后差异无统计学意义(P>0.05)。结论羟乙基淀粉淀粉作为小儿体外循环预充液在应用于先心直视手术效果确切,可替代部分血浆,白蛋白等血制品等使用。

Objective To explore the application of hydroxyethyl starch prefilling solution in cardiopulmonary bypass(CPB)of congenital heart disease in children.Methods Sixty children with congenital heart disease undergoing open heart cardiopulmonary bypass were randomly divided into two groups:hydroxyethyl starch group(experimental group)and blood products group(control group).The changes of hematocrit,Plasma colloid pressure,urine microprotein U-Mal and tumor necrosis factor TNT-ɑ,liver and kidney function were observed before and after CPB.Results There was no significant difference in the data between the experimental group and the control group before the beginning of CPB(P>0.05).There was no significant difference in plasma total protein,liver and kidney function,urine microprotei U-Mal and tumor necrosis factor TNT-ɑbetween the two groups before and after CPB(P>0.05).Conclusion Hydroxyethyl starch as infant cardiopulmonary bypass prefilling solution is effective in open heart surgery and can be used as a substitute for some plasma albumin and other blood products.