婴幼儿先心病的体外循环研究

Study of cardiopulmonary bypass in 115 pediatric patients

目的 :婴幼儿心内直视手术体外循环的研究。方法 :临床 115例婴幼儿分为体外循环管道不定型 (A组 )和体外循环管道定型 (B组 )两组。A组应用进口膜肺 35例 (5 7% ) ,鼓泡式氧合器 2 6例 (43% ) ,体外循环管道是临时改装。B组应用进口膜肺 4 9例 (91% ) ,鼓泡式氧合器 5例 (9% ) ,体外循环管道选择配置成型的婴幼儿管道 ,直径 6mm ,长度 10 0cm。结果 :两组患儿的年龄、体重无统计学差异 (P >0 0 1)。B组与A组相比 ,体外循环中晶体预充量由 (5 16± 172 )ml减少至 (40 0± 10 9)ml,差异性显著 (P <0 0 1)。总液量由 (933± 2 39)ml减少至 (6 2 5±171)ml,差异性显著 (P <0 0 1)。全血预充量由 (414± 183)ml减少至 (87± 10 6 )ml,差异性显著 (P <0 0 1)。两组稀释度无统计学差异 (P >0 0 1)。术后呼吸机辅助时间由 (2 4 4± 2 3 9)h缩短至 (13 2± 9 1)h ,差异性显著(P <0 0 1)。ICU时间由 (2 8± 1 5 )d缩短至 (1 6± 0 9)d ,差异性显著 (P <0 0 1)。全组 115例死亡 3例 (2 6 % )。结论 :选用优质婴幼儿膜肺 ,规范体外循环管道 ,总预充量控制在 5 0 0ml以下 。

Objective:Research of cardiopulmonary bypass of pediatric patients with congenital heart disease Methods: 115 cases were divided to two groups group A( n =61) were performed CPB with uncertain tubing system and group B( n =54) with certain tubing system Group A and B were both primed with Ring′s and colloid Results: There were no difference in age,body weight between group A and B The crystalloid prime volume in group B was less than it in group A( P <0 01) Also in group B,the total volume and the blood prime volume were much less than those in group A ( P <0 01) Beside these,The intubation time and ICU days for patients in group B were shorter than in group A ( P <0 01). Conclusion: It plays an very important roll in CPB technique that the certain tubing system,low prime volume and good membrane oxygenator in pediatric patients