不同基础预充液在婴幼儿体外循环中纠正酸失衡的应用研究  

Comparision of effects of different priming solution in pediatric open heart surgery

作　　者：陈祥舟[1] 刘梅[1] 彭莉[1] 胡卫[1] 杨宗英[1] 张秋霞[1] 詹颖[1] 黎小平[1] 

机构地区：[1]第三军医大学新桥医院全军心血管外科中心体外循环组,重庆400037

出　　处：《重庆医学》2010年第18期2464-2465,2467,共3页Chongqing medicine

摘　　要：目的比较不同基础预充液勃脉力-A（P-A）和复方林格氏液（C-R）在婴幼儿体外循环中纠正酸失衡的应用效果。方法选取：①18个月以下6 kg及以下常规体外循环（ECC）病例12例;②36个月以下6~10 kg常规ECC及深低温停循环（DH-CA）病例40例;③36个月以下10~15 kg常规ECC病例12例。将这3类病例随机分为C-R组和P-A组,其中①、③类病例每组6例,②类病例每组20例,分别使用不同的基础预充液。检测病例转前、转中血气pH值、BE值,统计病例术前预充的NaHCO3用量及整个ECC过程中的NaHCO3用量。结果 3类患者两组间转中血气pH、BE值都有显著差异,ECC过程中的NaHCO3用量有非常显著的差异。结论婴幼儿ECC采用P-A预充优于C-R,可更快使婴幼儿体内的酸代谢恢复平衡,并明显减少转流中NaHCO3的用量,降低血液稀释的程度。Objective To compare the effects of plasmalyte-A and compound ringer′s as priming solution in pediatric open heart surgery.Methods Three groups of patients：（1）less than 18 months and less than 6 kg with mild or moderate hypothermic extracorporeal circulation（ECC）,12 cases;（2）less than 36 months and 6-10 kg with mild ECC or underwent deep hypothermic circulatory arrest（DHCA）,40 cases;（3）less than 36 month and 10-15 kg with mild ECC,12 cases.The patients were randomly divided into two groups,compound ringer′s group（C-R group） and plasmalyte-A（P-A group）,6 cases of（1） and（3） sorts in each group,20 cases of（2） sort in each group.The concentrations of PH,BE of the preoperative and during ECC blood gas of patients were observed.Then to conduct the statistics on volume of the sodium carbonate using in the priming solution and during ECC.Results There were differences in PH,BE between C-R group and P-A group in every sort,but there were significant differences in the volume of sodium carbonate using during ECC between two groups in every sort.Conclusion As the priming solution,it is better to use plasmalyte-A than compound ringer′s,because the former can recover the acid-base balance of infants faster,and significantly decrease the volume of sodium carbonate using during ECC,decrease the hemodilution during pediatric open heart surgery.

关 键 词：体外循环 预充液 纠正酸失衡 

分 类 号：R726.5[医药卫生—儿科]