改良超滤在婴幼儿体外循环手术中的应用

目的探讨改良超滤在婴幼儿体外循环手术中的应用。方法选取先天性心脏病患儿220例,随机分为超滤组(n=180)和对照组(n=40)。采用旁气流通气监测法测定两组转流前、超滤前和超滤后的气道峰压(Ppeak)、气道平台压(Pplate)、肺顺应性(CL)。于超滤结束后30min检测血红蛋白压积(HCT)、血小板(PLT)、纤维蛋白原(FiB)。记录呼吸机辅助时间、术后引流量、输血量。结果全组无死亡,未发现与改良超滤有关的并发症。超滤组Ppeak和Pplat在超滤后较超滤前明显下降(P<0.05),CL则明显升高(P<0.05)。超滤组HCT、PLT、FiB超滤后半小时较对照组明显升高(P<0.05)。超滤组呼吸机辅助时间、术后引流量、输血量显著低于对照组(P<0.05)。结论改良超滤可明显提高HCT,并能改善呼吸功能,还明显减少围术期库血用量、胸引量、缩短术后呼吸机使用时间。

Application of modified ultrafiltration on cardiopulmonary bypass in Children

ObjectiveTo explore the clinical application of modified ultrafiltration(MUF) on cardiopulmonary bypass(CPB) in children. Methods20 children with congenital heart disease were selected and randomly divided into two groups: the modified ultrafiltration group(n=180) and the control group(n=40). The level of Ppeak, Pplat and CL by Side Stream Spirometry were measured at three points: before CPB, before and after MUF, and the volume of HCT, PLT and FiB were detected on 30 min after MUF, and the duration of ventilator, postoperative bleeding drainage volume and volume of blood transfusion were recorded. ResultsNo death occurred in all patients and no complication related to modified ultrafiltration was found. In the modified ultrafiltration group, Ppeak and Pplat were decreased and CL was increased after MUF. HCT, PLT and FiB were higher on 30 min after MUF than those of the control group, while the duration of ventilator, postoperative bleeding drainage volume and volume of blood transfusion were lower in the modified ultrafiltration group than those in the control group. ConclusionsMUF may obviously increase HCT, improve pulmonary function and decrease the duration of ventilator, postoperative bleeding drainage volume and volume of blood transfusion.