摘要
目的探讨比较改良超滤与常规超滤技术在婴幼儿先天性心脏病心内直视手术体外循环中的应用，以指导临床选择。方法选取2007年1月～2010年11月，无肝肾功能不全及其他合并症行先天性心脏痛心内直视手术患儿40例，随机分为超滤组（CUF组）20例，改良超滤（MUF）20例。分别统计比较转流前、转流结束和停机超滤结束后抽取动脉血测定血红细胞压积（Hct），术后24h胸腔引流量，呼吸机的使用时间，术后输血量。结果所有病例无死亡，均顺利出院，术后未发现与超滤及体外循环有关的并发症。转流前的红细胞压积2组间差异无显著性（P〉0．05）；转流中由于两组均有一定程度的血液稀释，Hct下降，但是MUF组仍高于CUF组（P〈0．05）；停机超滤结束后MUF组亦高于CUF组（P〈0．05），MUF组输入库血量、胸腔24h引流量、呼吸机辅助时间都明显低于CUF组（P〈0．05）。结论改良超滤能较快排除体内水分，减少术后输血并缩短拔管时间，有利于改善患儿愈后。
Objective To investigate the application of modified ultrafiltration（MUF） and conventional ul- trafihration（CUF） during and after cardiopulmonary bypass（CPB） for pediatric open heart surgery. Methods From January 2007 to December 2010 in our hospital,40 children with congenital heart diseases undergoing operations were classified randomly into modified ultrafiltration group （ MUF, n = 20 ） and conventional ultrafiltration group （ CUF, n = 20）. The clinical data of all tile infants, including hematocrit （Het） before CPB, intraoperative hematocrit, hematorit ＇alter CPB, volume of thoracic drainage within 24 hours after operation, mechanical ventilation support time after operation, vol- ume of postoperative blood transfusion were observed. Results No infant was dead and no MUF-related complications occurred in our research. The difference of Hot before CPB between the 2 groups was not significant （ P 〈 0.05 }. Accord- ing to some degree of the blood diluted, the level of Hot was lower than before after CPB in both groups, but compared with Hct level, MUF group was significantly higher（ P 〈 O. 05）. The dosage of bank blood,postoperative chest drain loss within 24 hours and ventilator time were significantly lower in MUF group（ P 〈 O. 05 ）. Conclusion MUF can filter sur- plus water efficiently,decrease blood transfusion requirement and remove the tube earlier,which is helpful in the conva- lescence of infants.
出处
《潍坊医学院学报》
2013年第2期117-119,共3页
Acta Academiae Medicinae Weifang
关键词
改良超滤
体外循环
先天性心脏病
婴幼儿
Modified uhrafiltration
Cardiopulmonary bypass
Congenital heart diseases
Infants
