体外循环微小化对低体重先天性心脏病患儿围术期输血量及预后的影响

The Effect of Miniaturization of Cardiopulmonary Bypass on Perioperative Blood Transfusion and Prognosis in Children with Low Birth Weight Congenital Heart Disease

目的对低体重先天性心脏病患儿应用体外循环(cardiopulmonary bypass, CPB)微小化系统,分析患儿围术期输血量及预后情况。方法按照随机数表法将2018年11月—2019年3月该院收治的128例低体重先天性心脏病患儿分为对照组(64例)和观察组(64例)。给予对照组患儿常规体外循环系统,给予观察组患儿微小化体外循环系统,观察并分析两组患儿围术期输血量及预后情况。结果两组患儿关胸时及术后的输血量比较,差异无统计学意义(t=0.502、1.202,P=0.617、0.232);观察组患儿于预充、CPB中的输血量及总计输血量均低于对照组,差异有统计学意义(t=22.531、8.458、6.067,P<0.001);观察组患儿围术期总输血率(79.69%)较对照组(100.00%)低,差异有统计学意义(χ^(2)=14.469,P<0.001);观察组患儿机械通气时间、住院时间及ICU停留时间均较对照组患儿低,差异有统计学意义(t=2.246、2.273、2.776,P=0.026、0.024、0.006)。结论针对低体重先天性心脏病患儿实施微小化体外循环系统,可缩短其机械通气时间、住院时间及ICU停留时间,减少围术期输血量,提高院内预后。

Objective To apply Cardiopulmonary bypass(CPB) miniaturization system to children with low birth weight congenital heart disease to analyze the blood transfusion volume and prognosis of children during perioperative period.Methods According to the random number table method, 128 children with low birth weight congenital heart disease admitted to the hospital from November 2018 to March 2019 were divided into a control group(64 cases) and an observation group(64 cases). The children in the control group were given conventional extracorporeal circulation system, and the children in the observation group were given a miniaturized extracorporeal circulation system. The perioperative blood transfusion volume and prognosis of the two groups of children were observed and analyzed. Results There was no statistically significant difference in the blood transfusion volume between the two groups of children when the chest was closed and after the operation(t=0.502, 1.202, P=0.617, 0.232);the blood transfusion volume and total amount of blood transfusion of the observation group in precharge and in the CPB was lower than that of the control group, and the difference was statistically significant(t =22.531, 8.458, 6.067,P <0.001);the total blood transfusion rate(79.69%) of children in the observation group was lower than that of the control group(100.00%), the difference was statistically significant(χ^(2)=14.469, P<0.001);the mechanical ventilation time, hospitalization time and ICU stay time of the observation group were lower than those of the control group, and the difference was statistically significant(t=2.246,2.273,2.776,P=0.026,0.024,0.006). Conclusion The implementation of a miniaturized extracorporeal circulation system for low-weight children with congenital heart disease can shorten their mechanical ventilation time,hospital stay and ICU stay time, reduce perioperative blood transfusion, and improve hospital prognosis.