不同超滤方法对小儿先心病术后凝血功能的影响  

Effects of different ultrafiltration methods on coagulation function of infants with congenital heart disease after surgery

作　　者：耿琳[1,2] 张儒舫[1,2] 金泉英[1,2] 王蓓旎[1,2] 

机构地区：[1]上海市儿童医院 [2]上海交通大学附属儿童医院心胸外科,200040

出　　处：《中国妇幼保健》2012年第24期3807-3809,共3页Maternal and Child Health Care of China

摘　　要：目的:比较不同超滤法对小儿先心术后凝血功能的影响。方法:将60例先天性心脏病患儿随机分成3组,分别为改良超滤组(A组),平衡超滤+改良超滤组(B组)和常规体外循环,不用超滤(C组)。监测患儿体外循环(CPB)前和CPB后的血小板计数(PLT)、CPB前的活化凝血时间(ACT)、CPB后30 min及60 min的ACT、CPB时间及术后出血量。结果:CPB前后的PLT差值、出血量A组与C组,B组与C组差异有统计学意义(P<0.05),而A组与B组比较无统计学差异(P>0.05);三组体外循环转流时间和CPB前后不同时间ACT的差值无统计学差异。结论:改良超滤法及平衡超滤+改良超滤法均可提高先心病患儿术后PLT水平并减少出血量,而平衡超滤法对凝血功能没有明显的保护作用。Objective：To compare the effects of different ultrafiltration methods on coagulation function of infants with congenital heart disease（CHD） after surgery.Methods：Sixty infants with CHD were randomly divided into modified ultrafiltration group（A group）,balanced ultrafiltration plus modified ultrafiltration group（B group）,and control group（C group）.Platelet counts before and after cardiopulmonary bypass（CPB）,activated coagulation times（ACT） before CPB,ACTs at 30 minutes and 60 minutes after CPB,CPB times,and the amounts of blood loss after operation in the three groups were monitored.Results：There was statistically significant difference in platelet difference before and after CPB,the amount of blood loss after operation between A group and C group,as well as between B group and C group（P0.05）,but there was no statistically significant difference between A group and B group（P0.05）;there was no statistically significant difference in CPB times and ACT differences before and after CPB at different time points among the three groups.Conclusion：Modified ultrafiltration,balanced ultrafiltration plus modified ultrafiltration both can increase platelet level after surgery and reduce the amount of blood loss after operation in the infants with CHD,but balanced ultrafiltration has no obvious protective effect on coagulation function.

关 键 词：平衡超滤法 改良超滤法 血小板计数 术后出血量 凝血功能 

分 类 号：R726.1[医药卫生—儿科]