血液回收机在新生儿围体外循环期的血液保护作用  

Effect of cell saver on blood protection during cardiopulmonary bypass in neonates

作　　者：刘晋萍[1] 崔勇丽[1] 冯正义[1] 赵举[1] 龙村[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院体外循环科,北京100037

出　　处：《中国输血杂志》2010年第6期433-435,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨使用自体血液回收机(CATS)处理红细胞悬液对先天性心脏病新生儿在围体外循环(CPB)期的血液保护作用。方法将2006年12月—2008年12月,36名行心脏手术体外循环的新生儿患儿分为对照组和实验组,18名/组。对比对照组未经CATS处理和实验组经CATS处理后红细胞悬液中血细胞比容、血钾、血糖、乳酸和缓冲碱(BE)等成分的水平差异;对比研究2组体外循环开始后不同时点血细胞比容、乳酸变化、红细胞悬液的预充量、尿量及颜色变化。结果转流前,实验组经CATS处理的红细胞悬液中血细胞比容明显高于对照组(t=2.491,P<0.01),而血钾、血糖和乳酸水平明显低于对照组(t=2.968、3.021、2.041,P<0.01);2组中的缓冲碱水平无明显差异;在体外循环初始10 min和结束时,实验组的血细胞比容均明显高于对照组(t=2.038、2.152,P<0.05);在体外循环初始10 min,实验组乳酸水平则明显低于对照组(t=2.856,P<0.01),在体外循环结束时,实验组乳酸水平低于对照组,但差异无统计学意义;实验组的红细胞悬液预充总量明显少于对照组(t=2.648,P<0.01)。结论自体血液回收机(CATS)可明显改善陈旧红细胞悬液质量,减少血液预充,在新生儿围体外循环期起到较好的血液保护作用。Objective To investigate the blood protective effect of continuous auto transfusion system（CATS）on packed red cells during neonatal cardiac surgery.Methods From December 2006 to December 2008,36 neonates undergoing cardiac surgery were divided to control group（group Ⅰ,n=18） and test group（group Ⅱ,n=18）.Levels of hematocrit,blood potassium,blood glucose and lactate in the packed red cells of CATS treated group（group Ⅱ） and nontreated group（group Ⅰ） were measured.And the different levels of hematocrit,lactate and the total priming volume of packed red cell were compared,and the urine volume and colour changes in the two groups at different time points were also observed.Results Before CPB,the hematocrit in groupⅡ was significantly higher than that of group Ⅰ（P0.01）,and the level of potassium,blood glucose and lactate were significantly lower than those of group Ⅰ（P0.01）.At the beginning and the end of CPB,the hematocrit in group Ⅱ were higher than those of group Ⅰ,and the level of lactate in group Ⅱ was significantly lower than that of group Ⅰ.The total priming of PRBC in group Ⅱ was less than group Ⅰ.Conclusion CATS can improve the quality of old stored blood and decrease the total priming of PRBC,and provide blood protection during neonatal cardiopulmonary bypass.

关 键 词：新生儿 体外循环 血液回收机 

分 类 号：R457.1[医药卫生—治疗学] R619.1[医药卫生—临床医学]