儿童心肺转流中不同预充基础液的应用比较  

Different Priming Solution in Pediatric Open Heart Surgery

作　　者：王伟[1] 朱德明[1] 张蔚[1] 傅惟定[1] 陈虹[1] 黄惠民[1] 

机构地区：[1]上海交通大学医学院附属新华医院上海儿童医学中心小儿心胸外科,上海200127

出　　处：《中国体外循环杂志》2006年第2期82-84,共3页Chinese Journal of Extracorporeal Circulation

基　　金：上海市科技发展基金资助项目(024119020)

摘　　要：目的比较不同预充基础液勃脉力-A和乳酸林格氏液在小儿心脏病手术中的使用结果。方法选取①5kg以下行深低温停循环(DHCA)病例,②10 kg以下常规心肺转流(Card iopu lmonary bypass,CPB)病例,③20 kg^40 kg常温CPB病例各20例。将这三类病例都随机分为乳酸林格氏液组和勃脉力-A组,每组10例,分别使用不同预充基础液。检测预充液和CPB过程中乳酸、葡萄糖和钾离子浓度。结果预充液中,三类患者两组间乳酸浓度都有非常显著差异,此后逐渐趋向减少。葡萄糖和钾离子浓度在同类患者两组间都没有显著差异。结论婴幼儿CPB采用勃脉力-A优于乳酸林格氏液,可以显著降低CPB过程中的乳酸浓度。OBJECTIVE The objective of this study is to compare the effects of Plasmalyte - A and Lactate Ringers as priming solution in pediatric open heart surgery. METHODS Three sorts of patients, 20 cases each sort, were collected： A. less than 5kg and underwent deep hypothermic circulatory arrest; B. less than 10kg with mild or moderate hypothermic cardiopulmonary bypass （CPB）, C. 20kg to 40kg with normonbermic CPB. Each sort of patients was randomly divided into two groups, lactate ringer＇s group （R group） and plasmalyte -A group （P group）, 10 patients each. The concentrations of lactate, glucose and K^＋ were measured after priming and during cardiopulmonary bypass. RESULTS There are significant differences in lactate between lactate ringer＇s group and plasmalyte - A group in every sort. Those differences were ameliorated with the CPB going on. There is no difference in glucose and K^＋ . CONCLUSION As the priming solution, it is better to use plasmalyte -A than lactate ringer＇s, because the former can significantly decrease the lactate concentration during pediatric open heart surgery.

关 键 词：心肺转流 预充液 

分 类 号：R726.5[医药卫生—儿科]