140例小儿先心手术的体外循环管理  

Management of CPB in 140 Pediatric Congential Surgeries

作　　者：袁志国[1] 蔡鹏举[1] 李晓静[1] 谢国柱[1] 孙灿林[1] 

机构地区：[1]泰州市人民医院麻醉科,江苏泰州225300

出　　处：《泰州职业技术学院学报》2009年第6期19-21,63,共4页Journal of Taizhou Polytechnic College

摘　　要：目的探讨小儿先心手术的体外循环管理。方法140例小儿在体外循环下进行外科矫治术。采用国产鼓泡和膜式氧合器,预充总量350-1200mL,中度低温中高流量灌注,应用晶体停跳液或高钾晶血1:4心肌保护液,复跳前10-15min采用浅低温血灌5-10min。结果主动脉阻断时间13-95min,体外循环时间26-125min。转流过程平稳,心脏自动复跳128例,10J除颤1次复跳12例,全部顺利停机。全部痊愈出院,无一例手术死亡或住院死亡。结论小儿先心病的体外循环管理应尽量减少预充,注重血液稀释程度,加强流量管理,重视心肌保护和肺保护,重视超滤器的应用,做好温度控制,加强监测手段。Aim To study the management of CPB in pediatric congenital cardiac surgery. Methods 140 cases of pediatric congenital cardiac surgery with CPB were studied. Homemade bubble oxygenator or membrane oxygenator were used. Precharge volume was 350-1200mL, moderate hypothermia and moderate-to-high volume were performed. Application crystal cardioplegia or high-K crystal-blood 1：4 cardioplegia, 5-10min warm blood was used 10-15min before recover. Results Aortic cross clamping time was 13-95min, CPB 26-125rain, automatic recover happened in 128 cases, recover after Cardiac defibrillation once with 10 J in 12 cases. All cases weaned from CPB successfully. No peri-operative death was founded. Conclusion In CPB of pediatric congenital cardiac surgery, less pre-charge volume, hemodilution degree, volume control, myocardial and pulmonary protection, filter application, temperature control was important and should be well managed.

关 键 词：体外循环 小儿 先天性心脏病 

分 类 号：R654.1[医药卫生—外科学]